When Should I Get a PSA?

April 28, 2023

when should i get a psa?

your risk matters

by Jamal Ross

Prostate cancer is one of the most common cancers worldwide and in the United States. About 1,600,000 men worldwide, and 165,00 men in the United States, are affected by prostate cancer each year. (1,2) Typically, a blood called a PSA, or Prostate Specific Antigen, is used to screen for prostate cancer. The chances of being affected by prostate cancer increases as men get older. Therefore, it is important to know the right time to be screened for prostate cancer. With this in mind, the timing of prostate cancer screening depends of whether a man is considered an average or high risk for this disease. Let’s find out more about the when one should be screened for prostate cancer.

The timing of screening for prostate cancer in average risk men is partly based on when doctors expect to find this disease in a man’s lifetime. Prostate cancer is rarely found before the age of 40 years, and In the United States, over 90% of new cases of prostate cancer are found in men ages 55 years and older. Partly for this reason, the United States Preventative Services Tasks Force (USPSTF) recommends that men ages 55 to 69 have a discussion with their doctor to determine if a prostate screening with a PSA blood test is the right choice. Interestingly, over 60% of the deaths from prostate cancer are seen in men over the age of 75 year. (3) It is though that there is about a 5-year lag time from when PSA levels rise and when prostate cancer is diagnosed. (4) Fortunately, when found early, the 5-year survival rate for prostate cancer is 100%. (3) This is amazing news and continues to highlight the importance of early disease detection.

It is important to identify those who are at higher risk for prostate cancer as these men will need to discuss the benefits of PSA blood testing, and other methods, at an earlier age with their doctor. Men who are carriers, or thought to be carriers, of the breast cancer (BRCA) gene are at a higher risk of prostate cancer and should be tested at an earlier age. African American men and those with have a first degree relative, such as a father or brother, diagnosed with prostate cancer before the age of 65 will should also consider testing for prostate cancer at an earlier age. For these all these high-risk men, discussions of prostate cancer screening should begin at the age of 40 (5,6)

In summary, the 5-year survival for prostate cancer approaches 100% when found early. Also, over 90% of all prostate cancers are found in men over the age of 55. Therefore, it is important to know when you should be tested. For those who are considered average risk, it is suggested that a discussion should take place at or after the age of 55 to determine if a PSA blood test is the right choice. For African American men, carriers of the breast cancer (BRCA) gene or those with a father or brother with prostate cancer before the age of 65 should have this discussion at a younger, specifically at or after the age of 40. In things, make sure to pray for guidance and understanding about this disease. Know your risks and become empowered to make choice that led to better health.

REFERENCES
1. Global Burden of Disease Cancer Collaboration; Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2017 Apr 1;3(4):524-548.
2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018 Jan;68(1):7-30.
3. National Institute of Health. Surveillance, Epidemiology, and End Results Program. Cancer Stat Facts: Prostate Cancer Available at: https://seer.cancer.gov/statfacts/html/prost.html (Accessed on September 19, 2021)
4. Gann PH, Hennekens CH, Stampfer MJ. A prospective evaluation of plasma prostate-specific antigen for detection of prostatic cancer. JAMA. 1995 Jan 25;273(4):289-94.
5. Wolf, Andrew MD, et al. “American Cancer Society guideline for the early detection of prostate cancer: update 2010.” CA: a cancer journal for clinicians2 (2010): 70-98.
6. Carter, H. Ballentine, et al. “Early detection of prostate cancer: AUA Guideline.” The Journal of urology2 (2013): 419-426.

Jamal Ross

Dr. Jamal Ross is an internist and pediatrician who possesses a passion for prayer and preventative medicine. He has worked in the fields of primary care and hospital medicine.

Related Posts

Prostate Cancer Wrap Up and Prayer

Prostate Cancer Wrap Up and Prayer

Prostate cancer in the second most common cancer in men worldwide and the single most common cancer in men in the United States. Worldwide over 1000 men are expected to die from prostate cancer every day. In the United States men have a 12-13% lifetime risk of developing prostate cancer. Prostate cancer presents a unique risk to men with no easy answers on how to find this disease at an early stage. Let’s review what we learned about prostate cancer so far. Afterwards, I would like to pray for you.

Fighting Metastatic Prostate Cancer

Fighting Metastatic Prostate Cancer

When prostate cancer has spread outside the prostate gland to affect the lymph nodes of other parts of the body, this is called metastatic prostate cancer. If you have been told that you have this disease, do not be discouraged. This is not a death sentence. There are many men that live a healthy and fulfilling life with this disease. At times, a doctor may even wait to begin treatment for metastatic prostate cancer if there are no symptoms. When treatment is necessary, there are several things one can expect.

Prostate Cancer Treatment

Prostate Cancer Treatment

There are many types of treatments for prostate cancer. Along with other medications, some men are treated with surgery or radiation. At other times, prostate cancer does not need to be treated. It can be “watched,” or monitored from year to year. In our previous blog and podcast, we discussed how the Gleason score can help guide a treatment course for prostate cancer. In addition to the Gleason score, there are other factors, such as the PSA level and tumor stage, that will be help plan a path to treat prostate cancer. Let’s find out how the Gleason score, PSA level, and tumor stage are used to help formulate a plan to treat prostate cancer.

Gleason Score

Gleason Score

There are many types of treatments for prostate cancer. Along with other medications, some men are treated with surgery or radiation. At other times, prostate cancer does not need to be treated. It can be “watched,” or monitored from year to year. The decision for treatment with surgery, radiation or watchful waiting depends on many factors. One is these factors is called a Gleason score. After undergoing a prostate biopsy, a doctor that specializes in looking at tissues on microscope, also known as a pathologist, will give a score to grade the cancer cell from not aggressive to aggressive. This is called a Gleason score. Let’s find out more about the Gleason score and how this number can be used to guide the treatment of prostate cancer.

Comments

0 Comments

Submit a Comment

Your email address will not be published. Required fields are marked *