The PSA blood test for prostate cancer: When men need it—and when they don’t

| Posted On Mar 16, 2015 | By:

PSA TestingFor years, doctors have used a PSA blood test to screen men for prostate cancer. The test measures a protein made by the prostate gland, called a prostate-specific antigen (PSA).

But the PSA test can do more harm than good. Here’s why:

The test is often not needed.

Most men with high PSAs don’t have prostate cancer. Their high PSAs might be due to:

Up to 25% of men with high PSAs may have prostate cancer, depending on age and PSA level. But most of these cancers do not cause problems. It is common for older men to have some cancer cells in their prostate glands. These cancers are usually slow to grow. They are not likely to spread beyond the prostate. They usually don’t cause symptoms, or death.

Studies show that routine PSA tests of 1,000 men ages 55 to 69 prevent one prostate cancer death. But the PSA also has risks.

There are risks to getting prostate cancer tests and treatments.

If your PSA is not normal, you will probably have a biopsy. The doctor puts a needle through the wall of the rectum and into the prostate to take a few samples. Biopsies can be painful and cause bleeding. Men can get serious infections from biopsies, and they may need hospital care.

Surgery or radiation are the usual treatments for prostate cancer. They can do more harm than good. Treatment can cause serious complications, such as heart attacks, blood clots in the legs or lungs, or even death. In addition, 40 men out of 1,000 will become impotent or incontinent from treatment.

Screenings can lead to high costs.

The cost for a PSA test is fairly low—about $40.

If your result is abnormal, the costs start adding up. Your doctor will usually refer you to a urologist for a biopsy. Costs may include:

If the biopsy causes problems, there are more costs. You might also have hospital costs.

When is a PSA test needed?

If you are age 50 to 74, you should discuss the PSA test with your doctor. Ask about the possible risks and benefits.

Men under 50 or over 75 rarely need a PSA test, unless they have a high risk for prostate cancer.

Tips for deciding about the PSA test

Should you have a PSA test?

There is no good evidence that routine screening in low-risk men saves lives. Consumer Reports agrees with the U.S. Preventive Services Task Force that screening low-risk men for prostate cancer does more harm than good.

Talk to your doctor.

Consider your risks.

The PSA test is most useful for checking on patients who already have prostate cancer. This includes men who had surgery or radiation. Doctors also use the PSA test to check on men who have chosen “watchful waiting.” These men have low-risk prostate cancer. These cancers usually spread slowly and do not cause death. Many men choose watchful waiting instead of treatment, because the side effects of treatment can be serious. If the PSA test result shows a change, the doctor can start treatment.

This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2014 Consumer Reports. Developed in cooperation with the American Academy of Family Physicians. To learn more about the sources used in this report and terms and conditions of use, visit ConsumerHealthChoices.org/about-us/.

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Comments

  1. Very nice and helpful article Thanks for including it

    Comment by Tobin Gerhart on March 17, 2015 at 11:51 am

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