What New Prostate Cancer Screening Guidelines Mean for You

Men between the ages of 50 and 69 are now being urged by the American Cancer Society to get a blood test for prostate cancer every two years – a departure from previous screening guidelines.

This is the first step toward a more regular screening approach for prostate cancer, the most common cancer in U.S. men. About 1 in 8 men will be diagnosed with prostate cancer, with 60 percent of those cases occurring at 65 years or older.

Until now, official prostate cancer screening guidelines have been approached as more of a personal decision by patients after consultation with their doctors. Screenings for other common cancers (including lung, breast and colon) follow specific age-related guidelines.

The new prostate cancer guidelines also suggest a starting age of 45 for black men and men with a strong family history of prostate cancer.

What Is a PSA Blood Test and What Is a Normal Score by Age?

A PSA blood test measures your levels of prostate specific antigen, an enzyme produced by the prostate. It is mostly found in semen, but small amounts are also released into your bloodstream.

While it is natural to be found in your blood, higher-than-expected PSA levels can be a sign of prostate cancer, which can boost production of the enzyme. However, a high PSA score does not necessarily mean you have prostate cancer.

Your PSA score is more of an indicator that can suggest the need for further evaluation and testing. PSA levels, which are measured in nanograms per milliliter (ng/mL) can naturally increase as you age. There are no hard and fast rules about a good or bad PSA score. But in general, these scores may suggest that more attention is warranted:

• Age 40–49: 2.5 ng/mL or higher
• Age 50–59: 3.5 ng/mL or higher
• Age 60–69: 4.5 ng/mL or higher
• Age 70+: 6.5 ng/mL or higher

Your PSA number can rise for a variety of reasons, including inflammation, infection or a tumor. Prostates also differ from one person to the next. So, think of the PSA as a snapshot of your prostate’s condition. It doesn’t mean you have a good or bad condition. But it can lead to answers.

What Happens If Your PSA Score Is High?

A high PSA score will spark conversations with your doctor about various options. Those include:

• Digital rectal exam: This is a physical examination of your prostate for any hard lumps or abnormalities that could suggest cancer.
• Repeated PSA test: A follow-up test may be suggested to confirm the PSA number.
• Prostate MRI: The noninvasive test provides detailed images of the prostate. It can reveal the size of the prostate and the presence of potential tumors or areas of inflammation.
• Additional blood/urine tests: There are other lab tests available for patients who cannot or will not take an MRI test.
• Biopsy: Your doctor uses a needle to take a small tissue sample from your prostate. If cancer is detected, this can also help determine how fast the cancer is likely to spread.

Keep in mind that prostate cancer has few, if any, symptoms during its early stages, when it is most easily treated. Regular screenings can help find the disease before it reaches advanced stages, when aggressive treatment – including the removal of your prostate – may be required.

When a tumor is detected early, you have many more options. Depending on your age and aggressiveness (some tumors grow very slowly) of the cancer, your doctor may start with a surveillance schedule to keep an eye on the tumor. There are various treatments and therapies for faster-growing tumors.

Why Are Prostate Cancer Screening Guidelines Debated?

Historically, the value of prostate cancer screenings have been the subject of some debate, though most urologists have long championed their importance.

Screening guidelines are issued by several organizations, including the influential U.S. Preventive Services Task Force, whose recommendations are factored into health insurance coverage.

The organization is now reviewing its 2018 guidelines, which call screening an “individual” decision for men aged 55 to 69 years old. Among other things, organization notes potential harms from “overdiagnosis and overtreatment.”

But there have been many changes in treatment protocols in the nearly 10 years since those guidelines were published. Biopsies, for example, are now performed under anesthesia – similar to a colonoscopy (without the unpleasant prep). Don’t let your fears of a high PSA number keep you from gaining valuable insights into your prostate health.

This content is not AI generated.