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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 irregularities. The PSA test is a blood test that measures prostate-specific antigen, an enzyme produced only by the prostate. The doctor may use this test to see if the PSA level is within normal limits and to check for any change in PSA levels compared to previous PSA tests.

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

Recommendations

There is good evidence that PSA screening can detect early-stage prostate cancer.¹ Evidence is mixed about whether early detection improves health outcomes. The benefits of prostate cancer screening include potentially finding and treating prostate cancer early, when treatment may be more effective. The potential risks of prostate cancer screening 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.

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, which state that there is insufficient evidence to recommend for or against routine screening for prostate cancer using PSA or DRE.

Current evidence is insufficient to determine whether the potential benefits of prostate cancer screening outweigh its potential risks in men younger than 75 years of age. The USPSTF recommends against screening for prostate cancer in men aged 75 years or older.¹

Given the uncertainty about the benefits of screening, CDC supports informed decision making, which occurs when a man understands the nature and risks of prostate cancer; understands the risks and 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

¹U.S. Preventive Services Task Force. Screening for Prostate Cancer. August 2008.