Refinements to PSA Testing May Save Lives

Changing the way the PSA screening test is scheduled could help more men find prostate cancer early, as well as reduce the number of unnecessary biopsies.

PSA stands for prostate-specific antigen, a blood protein that helps doctors screen for prostate cancer. Higher PSA levels may indicate that a man has prostate cancer - or is at higher risk for the disease.

Current guidelines from the American Cancer Society suggest that men discuss the PSA test with their doctor when they turn 50. In contrast, the American Urological Association recommends that men discuss PSA screenings with their doctor no later than age 45, and preferably at age 40.

Different age suggested

The results of several recent studies, however, argue that men should be screened between ages 44 and 50 to determine a base line for how likely they are to develop cancer later in life. A PSA level of 1.5 or greater before age 50 would point to the need to have a follow-up screening in two years or as recommended by their doctor.

And men older than 60 with low PSA levels may not need follow-up testing because their risk for developing prostate cancer is minimal.

The study findings suggest that some men may only need three PSA screenings: the first between ages 44 and 50, the second between ages 51 and 55, and, if their PSA levels are still low, a third at age 60. Men with higher PSA levels would need more screenings.

Change in focus

"Instead of testing all men each year or every two years, screening and surveillance efforts can be focused on early detection of prostate cancer in those men who are found to be at high risk of death from the disease," says Hans Lilja, M.D., lead author of one study and researcher at Memorial Sloan-Kettering Cancer Center in New York City.

Another study of PSA looked at how fast PSA levels rose by looking at PSA velocity. Adding this measurement to the standard PSA screening may help find more aggressive tumors, the researchers say.

Always talk with your health care provider to find out more information.