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Screening

Tests

The two most common tests used by physicians to detect prostate cancer are the digital rectal examination (DRE) and the prostate-specific antigen (PSA) test. For the DRE, the doctor inserts a gloved and lubricated finger into the rectum. This allows the doctor to feel the back portion of the prostate (where most cancers begin) for size and any irregularities. The PSA test is a blood test that measures the prostate-specific antigen, an enzyme produced only by the prostate, to see if the PSA level is within normal limits. The doctor also may use this test to check for any change in PSA level compared to the previous PSA test.

For more information, please see Prostate Cancer Screening: A Decision Guide.

Recommendations

Although there is good evidence that PSA screening can detect early-stage prostate cancer, evidence is mixed and inconclusive about whether early detection improves health outcomes. Additionally, prostate cancer screening is associated with important harms, which include anxiety and follow-up procedures based on test results that sometimes are false-positive, as well as the complications that may result from treating prostate cancers that, if left untreated, might not have affected the man's health.

• Because current evidence is insufficient to determine whether the potential benefits of prostate cancer screening outweigh important harms, there is no scientific consensus that such screening is beneficial.¹



• CDC and other federal agencies follow the prostate cancer screening guidelines set forth by the U.S. Preventive Services Task Force, led by the Agency for Healthcare Research and Quality.



• CDC promotes informed decision making, which occurs when a man understands the nature and risks of prostate cancer; understands the risks of, benefits of, and alternatives to screening; participates in decision making at a level he desires; and makes a decision consistent with his preferences and values, or defers the decision to a later time.

Reference

1. U.S. Preventive Services Task Force. Screening for prostate cancer: recommendation and rationale. Annals of Internal Medicine 2002;137:915–916.