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Why it's done
By Mayo Clinic staffProstate cancer is the second most common cancer in men after skin cancer. Early detection may be an important tool in getting appropriate and timely treatment.
Cancerous (malignant) tissue of the prostate usually produces more PSA than healthy tissue. The PSA test can detect high levels of PSA that may indicate the presence of prostate cancer. However, other conditions, like an enlarged or inflamed prostate, may also increase PSA levels. Therefore, 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 in order to reach the prostate. By feeling or pressing on the prostate, your doctor may be able to judge whether it's enlarged or has abnormal lumps.
Neither the PSA test nor the digital rectal exam provides enough information for your doctor to make a diagnosis of prostate cancer. Abnormal results in these tests, however, may lead your doctor to order a prostate biopsy, a procedure that removes samples of tissue for laboratory examination. A diagnosis of prostate cancer is based on the results of a biopsy.
Other reasons for PSA tests
For men who have already been diagnosed with prostate cancer, the PSA test may be used to:
- Monitor possible changes in the tumor
- Judge the effectiveness of a treatment
- Check for recurring cancer
- Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine. 2008;149:185.
- Overview: Prostate cancer. How many men get prostate cancer? American Cancer Society. http://www.cancer.org/docroot/CRI/content/CRI_2_2_1X_How_many_men_get_prostate_cancer_36.asp?sitearea=. Accessed Feb. 16, 2009.
- The prostate-specific antigen (PSA) test: Questions and answers. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/detection/PSA. Accessed Feb. 12, 2009.
- What You Need to Know About Prostate Cancer. Rockville, Md.: National Cancer Institute; 2008.
- Can prostate cancer be found early? American Cancer Society. http://www.cancer.org/docroot/cri/content/cri_2_4_3x_can_prostate_cancer_be_found_early_36.asp. Accessed Feb. 12, 2009.
- Lin K, et al. Benefits and harms of prostate-specific antigen screening for prostate cancer: An evidence update for the U.S. Preventive Services Task Force. Annals of Internal Medicine. 2008;149:192.
- Prostate cancer: Screening. Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/prostate/basic_info/screening.htm. Accessed Feb. 15, 2009.
- Ferrini R, et al. Screening for prostate cancer in American men: American College of Preventive Medicine Practice Policy Statement. American College of Preventive Medicine. http://www.acpm.org/prostate.htm. Accessed Feb. 15, 2009.
- Early detection of prostate cancer. American Urological Association. http://www.auanet.org/content/guidelines-and-quality-care/policy-statements/e/early-detection-of-prostate-cancer.cfm. Accessed Feb. 16, 2009.
- Andriole GL, et al. Mortality results from a randomized prostate-cancer screening trial. New England Journal of Medicine. 2009;360:1310.
- Schroder FH, et al. Screening and prostate-cancer mortality in a randomized European study. New England Journal of Medicine. 2009;360:1320.
- Carroll P, et al. Prostate-specific antigen best practice statement: 2009 update. American Urological Association. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/psa09.pdf. Accessed April 28, 2009.
