By Andrea Hargraves 
When approaching age 50, men should have a prostate-specific antigen (PSA) test annually.
Prostate cancer remains a major concern in my practice, which is why I stress the importance of early detection. The American Cancer Society estimates that there will be approximately 300,000 new cases of prostate cancer and approximately 35,000 deaths in 2024 (US data).
A vital tool in this endeavor to diagnose and treat this common cancer is the prostate-specific antigen, or PSA, test, a simple blood test that provides valuable insights into prostate health. Starting at age 50, men should get tested annually. If you have a family history, risk factors, or are black, you may need to start as early as age 40.
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Prostate-specific antigen testing is the cornerstone of early detection of prostate cancer. When combined with other diagnostic tests and clinical evaluations, it helps identify prostate cancer in its early stages, when the results of surgical treatment and radiation therapy for prostate cancer have the best chance of cure.
Regular PSA checks are especially crucial for high-risk individuals, such as those with a family history of prostate cancer or older adults. A blood test is also necessary for the average man during his routine annual checkup with his primary care physician.
What else can affect PSA levels?
Conditions such as an enlarged prostate, recent sexual activity, or prostate infection can contribute to high PSA levels, which may cause unnecessary alarm. By considering these factors along with PSA test results, healthcare professionals can provide more informed guidance and avoid unnecessary interventions.
Bypass PSA screening
Blood and urine tests can now identify specific genetic markers associated with prostate cancer, providing insight into each patient's unique risk profile.
When combined with traditional PSA testing, these tests provide a more comprehensive picture of each patient's prostate health and cancer risk. These tests, along with the initial PSA test, can help us determine who can benefit most from further investigations, such as a prostate biopsy.
Prostate MRI technology provides a detailed, high-definition view of the prostate gland. This allows us to identify suspicious lesions within the prostate gland that may harbor prostate cancer. These “hot spots” are then targeted using MRI fusion technology, where MRI images are combined with live ultrasound images during a prostate biopsy. Using this imaging tool allows you to detect cancer more accurately during a prostate biopsy.
Together, these additional tests can increase our ability to detect prostate cancer, leading to more effective and personalized treatments.
More prostate cancer testing and screening for black men
Recent research and guidelines from the Prostate Cancer Foundation highlight an important update in prostate cancer screening for black men. Recognizing its greater risks, guidelines recommend starting PSA testing between the ages of 40 and 45, earlier than current recommendations from other organizations. Regular checkups, preferably annually, should continue until at least age 70. These updates aim to address disparities in prostate cancer outcomes among Black men by providing essential, life-saving screening recommendations.
Recent findings suggest that lowering the recommended age for initial PSA testing in black men could reduce prostate cancer deaths by about 30% without significantly increasing rates of “overdiagnosis.” Doing so underscores the importance of screening methods tailored to at-risk populations, especially black men, who are twice as likely to develop and die from prostate cancer than white men.
Proactive steps towards prostate health for all men
Prostate-specific antigen (PSA) testing remains a critical tool in detecting prostate cancer, giving men the opportunity to intervene earlier and get better outcomes. Staying up to date on screening guidelines and understanding individual risk factors is vital. By prioritizing proactive healthcare and engaging in open discussions with healthcare professionals, men can take control of their prostate health and contribute to reducing the burden of prostate cancer in our communities.
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