What is a PSA Test/Screening?

Prostate-specific antigen (PSA), is a protein produced by both the normal and cancerous cells of the prostate gland. Some of it escapes into your bloodstream, but the amount depends on your age and the status of your prostate. For this test, a blood sample is collected and sent to a laboratory for analysis. Typically, the findings are provided in nanograms of PSA per milliliter of blood (ng/mL).

The PSA test is a blood test used to detect carcinoma prostate. Low PSA level is normal, but elevated levels in males might be caused by a variety of illnesses other than prostate cancer. As a result, identifying the reason why you have a high PSA number is critical. Other conditions that might cause elevated PSA levels include:

• Prostate enlargement (BPH/BEP)
• Prostatitis (inflammation of the prostate)
• Abscess of the prostate
• Infection of the urinary tract
• Other typical prostate issues

Urologists frequently use the PSA test in conjunction with a digital rectal exam (DRE) to help determine the nature of a problem in men who report prostate symptoms. The PSA test and digital rectal exam do not give enough details to identify prostate cancer. If the findings of these tests are abnormal, urologists may propose further testing including prostate biopsies.

Why screening for PSA (Prostate Specific Antigen)?

Prostate cancer is common, and it is one of the most common causes of cancer death. According to the Indian Council of Medical Research (ICMR), over 45,000 men are diagnosed with prostate cancer in the country each year, making it the 3rd most common cancer in men. That’s about 123 cases a day. Among these cases, over 10,000 men succumb to illness and death. Prostate cancer has climbed from the eighth most prevalent cancer in men in the 1990s to the third most common cancer in men by 2015. As prostate cancer is a slow-growing tumor, it is treatable if caught early, with a survival rate of up to 90%. PSA screening and rectal prostate examination as suggested reduces the risk of late-stage prostate cancer and long-term problems.

When should you be screened for Prostate Cancer?

The answer is influenced by a variety of factors, including your age and family history. Several doctors and institutes advised routine yearly PSA screening for prostate cancer beginning at the age of 50 before 2008.

Although the current advice is to begin screening at the age of 55, however, you might need PSA testing between the ages of 40 and 54 if you have/had:

• Any first-degree relative like a father or brother with prostate cancer
• Minimum of two prostate cancer patients in your extended family

Prostate Cancer Screening for Men Aged 55 to 69:

This is the age group in which males will benefit most from screening. This is because this is the time when:

• Men are more prone than women to develop cancer.
• When the therapeutic advantages surpass any potential risk of treatment side effects, the therapy makes the most sense.
• Most men, if they live long enough, are susceptible to prostate cancer. Some prostate cancers are aggressive, while others are slow-growing. Before considering the risks and advantages of therapy, experts will take into account your age and other considerations.

How often should I have a PSA test?

As previously stated, PSA screening is not always reliable. PSA testing can be untrustworthy, resulting in false-positive or false-negative findings.

Having said that, the frequency of prostatespecific antigen (PSA) testing is determined by a variety of factors, including age, family history, the current state of health, and even ethnicity.

If the patient's PSA level is less than 2.5 ng/ml, he will need to be checked every two years. If the PSA result is more than 2.5 ng/ml, the frequency is increased to once a year.

Men with PSA levels of 1 ng/ml are not at risk for prostate cancer and may only need to be screened every three to five years.

Dr. Amit Goel is a Consultant Laparoscopic/ Robotic Urologist & Renal Transplant Surgeon. He has over 15 years of experience in successfully treating complex urological diseases. His expertise includes diagnosing & treating Kidney stones, prostate enlargement, prostate cancer, kidney cancer, bladder cancer & incontinence, male infertility & erectile dysfunction.