Since abnormal PSA levels could indicate the presence of prostate cancer, PSA tests might be used as a preliminary screening test for prostate cancer. This test is sometimes included in comprehensive health or cancer screening packages for males.
What is a PSA Screening Test?
A PSA test is a blood test that measures the amount of PSA in your blood.
What are the possible reasons for abnormal PSA levels apart from prostate cancer?
While abnormal PSA levels can indicate cancer, PSA levels can also be elevated because of
- Rigorous exercise
- Sex
- Other prostate conditions, such as benign prostatic hyperplasia (BPH) or prostatitis.
On the other hand, PSA levels can also be suppressed by other factors such as taking certain medications.
Should I do a PSA test?
Due to the limitations of the test, PSA screening for prostate cancer is a very controversial area. There is a variation in the recommendation for PSA screening from major bodies such as the American Cancer Society, United States Preventive Services Task force (USPTF) and United Kingdom National Screening Committee.
The benefits to screening need to be weighed against the potential for:
- Over-diagnosis – For example, raised PSA levels does not mean cancer is present, and even if cancer were present, a significant number of prostate cancers are slow-growing and do not result in symptoms or illness, which may mean that treatment may not be necessary. Thus, such scenarios can cause stress and anxiety with no benefit to the patient.
- Complications related to subsequent investigations and treatment – Further testing or treatment may lead to issues such as pain, bleeding and infection.
Based on the 2018 USPTF recommendation, PSA testing can be considered for average-risk (no family history) males aged between 55 to 69, who have a life expectancy in excess of 10 years after discussion with a physician on the pros and cons of the screening.
The decision to screen is considered individually for each patient, especially for higher-risk (positive family history) males.