PSA ‘best option’ in prostate testing - Wellness

PSA ‘best option’ in prostate testing

David J. Kaplan, M.D. | Posted: Wednesday, June 4, 2014 10:00 am

This year alone, 29,840 American men will die from prostate cancer. The National Cancer Institute also estimates that 233,000 men will be newly diagnosed with the disease this year. Traditionally, prostate cancer has been diagnosed with a two-part process. The first is a digital rectal exam (DRE), in which a physician examines the prostate by palpating its surface to determine the presence of any abnormalities such as firmness, asymmetry or a discrete firm area called a nodule. The second test that is commonly used to determine the likelihood of prostate cancer is measurement of prostate-specific antigen, also known as the PSA blood test. This is a blood test that was first approved by the FDA in 1986, and in 1996 was approved in combination with DRE to diagnose prostate cancer in men who do not manifest any symptoms.

In many ways, PSA is an excellent test. It is simple, reproducible, relatively easy to obtain and inexpensive. Until this year, many doctors and most professional medical organizations have advocated for annual DRE and PSA screening starting at age 50 in men at average risk, and beginning at age 40 in men thought to be at increased risk for having prostate cancer. Those high-risk patients include African-American men; men with first-degree relatives who carry a diagnosis of prostate cancer; and men who consume a high-fat diet or drink alcohol. It is also well established that PSA in combination with DRE allows us to detect prostate cancer at earlier stages.

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