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Prostate Cancer – PSA Screening

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Well, depending on your age and other risk factors, you should have a blood test called PSA or prostatic specific antigen. This is one of the most effective screening tools we have in medicine. PSA is a reproductive protein produced by the glandular tissue of the prostate. Normally, the serum concentration of PSA is low, but it can increase in certain instances, including infection and some inflammatory reactions, and also, especially in prostate cancer. Due to the association with prostate cancer, PSA can be used to screen men at risk. Additionally, a digital rectal exam can detect a palpable cancerous tumor that in some rare instances does not reflect an elevated PSA. The American Neurological Association has released the following PSA screening guidelines. These are recommendations. The most important thing that your healthcare provider should do is involve you in the decision to screen or not to screen.

Having said that, the guidelines are: PSA screening in men under the age of 40 is not recommended. Routine screening in men between the ages of 40 to 54 years of age not at risk, such as family history or of African descent, is discouraged. For men ages 55 to 69 years of age, the decision to undergo PSA screening involves weighing the benefits of preventing prostate cancer mortality versus the potential harm associated with screening and treatment. For this reason, shared decision-making is recommended for men age 55 to 69, who don’t have a strong family history and who are not of African-American descent. The decision to screen will be based on the patient’s preferences. Routine screening is not recommended for men over the age of 70 or with a life expectancy of less than 10 to 15 years of age.

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