There are several National Guidelines for when men should get screened with PSA. All recommend that men make a shared decision with their doctor about whether to be tested for prostate cancer based on age, life expectancy, and general health status. The recommendation from the American Cancer Society :
Men “make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting information about the uncertainties, risks, and potential benefits of prostate cancer screening.”
Generally, screening should take place for:
- Age 50 for men at average risk of prostate cancer are expected to live at least ten more years.
- Age 45 for men at substantial risk of developing prostate cancer. This includes African Americans and men with a first-degree relative (father, brother, or son) diagnosed with prostate cancer early (younger than 65).
- Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer early).
After these discussions, men who still want to be screened should get the PSA blood test. The digital rectal exam may also be used as a part of the screening.
- If PSA is elevated, get a 4K Score (see Genetics tab) blood test to determine if you have aggressive cancer.
- If PSA is raised and the 4K score is high, get a Multiparametric MRI. This will detect the location of cancer and direct where to biopsy
- Consider Targeted Fusion Biopsy to reduce complications and improve the accuracy of the Biopsy.