Screening

Prostate cancer screening means looking for cancer before it causes symptoms. This helps to find cancer at an early stage when it may be easier to treat.

Tests that are commonly used to screen for prostate cancer are—

• Digital rectal exam (DRE): A doctor or nurse will insert a gloved, lubricated finger into the rectum to feel the prostate. This allows the examiner to estimate the size of the prostate and feel for any lumps or other abnormalities.
• Prostate specific antigen test (PSA): The PSA test is a blood test that measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.

As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands produce more PSA than others. PSA levels also can be affected by—

• Certain medical procedures.
• An enlarged prostate.
• A prostate infection.

Because many factors can affect PSA levels, your doctor is the best person to interpret your PSA test results.

Should I Get Screened for Prostate Cancer?

Not all medical experts agree that screening for prostate cancer will save lives. Currently, there is not enough evidence to decide if the potential benefits of prostate cancer screening outweigh the potential risks.

Potential benefits of prostate cancer screening include—

• Screening can detect cancers early.
• Treatment for prostate cancer may be more effective when it is found early.

Potential risks of prostate cancer screening include—

• False positive test results (indicating that you have prostate cancer when in fact you do not) that lead to further tests and can cause anxiety.
• Treatment of some prostate cancers that may have never affected a man's health even if left untreated.
• Treatment may lead to serious side effects such as impotence (inability to keep an erection) and incontinence (inability to control the flow of urine, resulting in leakage).

CDC and other federal agencies follow the prostate cancer screening guidelines set forth by the U.S. Preventive Services Task Force, which state that there is insufficient evidence to recommend for or against routine screening for prostate cancer using PSA or DRE.

Informed Decision Making

Given the uncertainty about the benefit of screening, CDC supports informed decision making. Informed decision making occurs when a man—

• Understands the nature and risk of prostate cancer.
• Understands the risks of, benefits of, and alternatives to screening.
• Participates in the decision to be screened or not at a level he desires.
• Makes a decision consistent with his preferences and values.

CDC has developed materials about prostate cancer screening which are designed to promote discussions between men and physicians and to help men make informed decisions about prostate cancer screening. These materials include—

Prostate Cancer Screening: A Decision Guide (PDF-118KB) is an easy-to-read booklet, organized in question and answer format, designed to help a man decide whether screening is right for him. The guide discusses the prostate, prostate cancer, and the available screening tests.

Prostate Cancer Screening: A Decision Guide for African Americans (PDF-155KB) targets African-American men. At all ages, African-American men die of prostate cancer more often than other men do. The reasons for the variation among groups are unknown, making it critical that African-American men know the facts about prostate cancer and the available screening tests.

La Detección del Cáncer de Próstata: Una Guía para Hispanos en los Estados Unidos (PDF-512KB) is 24-page booklet, written in Spanish, provides basic information and encourages Hispanic men to decide whether screening is the right choice for them.