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By Mayo Clinic staffProstate cancer is the most common nonskin cancer in men, and it's the leading cause of cancer-related death in men. Early detection may be an important tool in getting appropriate and timely treatment.
Men with prostate cancer may have elevated levels of PSA. But many noncancerous conditions can also increase a man's PSA level. Although the PSA test can detect high levels of PSA in the blood, the test doesn't provide precise diagnostic information about the condition of the prostate.
The PSA test is only one tool used to screen for early signs of prostate cancer. Another common screening test, usually done in addition to a PSA test, is a digital rectal exam. In this test, your doctor inserts a lubricated, gloved finger into your rectum to reach the prostate. By feeling or pressing on the prostate, the doctor may be able to judge whether it has abnormal lumps or hard areas.
Neither the PSA test nor the digital rectal exam provides enough information for your doctor to diagnose prostate cancer. Abnormal results in these tests may lead your doctor to order a prostate biopsy. During this procedure, samples of tissue are removed for laboratory examination. A diagnosis of cancer is based on the biopsy results.
Other reasons for PSA tests
For men who have already been diagnosed with prostate cancer, the PSA test may be used to:
- Help decide if and when to begin treatment
- Judge the effectiveness of a treatment
- Check for recurring cancer
- Prostate-specific antigen (PSA) test. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/detection/PSA. Accessed April 5, 2011.
- Prostate cancer: Early detection. American Cancer Society. http://www.cancer.org/Cancer/ProstateCancer/MoreInformation/ProstateCancerEarlyDetection/prostate-cancer-early-detection-pdf. Accessed April 5, 2011.
- Prostate cancer screening. Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/prostate/basic_info/screening.htm. Accessed April 5, 2011.
- Gjertson CK, et al. Use and assessment of PSA in prostate cancer. Medical Clinics of North America. 2011;95:191.
- Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Rockville, Md.: U.S. Preventive Services Task Force. http://www.uspreventiveservicestaskforce.org/draftrec3.htm#recd. Accessed Oct. 11, 2011.
- Prostate cancer overview. How many men get prostate cancer? American Cancer Society. http://www.cancer.org/Cancer/ProstateCancer/OverviewGuide/prostate-cancer-overview-key-statistics. Accessed April 5, 2011.
- What You Need to Know About Prostate Cancer. Rockville, Md.: National Cancer Institute; 2008. http://www.cancer.gov/cancertopics/wyntk/prostate/page1. Accessed April 8, 2011.
- Guideline synthesis: Screening for prostate cancer. National Guideline Clearinghouse. http://www.guideline.gov/syntheses/printView.aspx?id=16398. Accessed April 5, 2011.
- Shteynshlyuger A, et al. Prostate cancer: To screen or not to screen? Urologic Clinics of North America. 2010;37:1.
- Greene KL, et al. Prostate specific antigen best practice statement: 2009 update. The Journal of Urology. 2009;182:2232.
- AUA Foundation responds to American Cancer Society guideline for the early detection of prostate cancer. AUA Foundation. http://www.auanet.org/content/press/press_releases/article.cfm?articleNo=179. Accessed April 5, 2011.
- Wolf AMD, et al. American Cancer Society guideline for the early detection of prostate cancer. CA: A Cancer Journal for Clinicians. 2010;60:70.
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