Prostate cancer screening

Is it right for you?

Prostate cancer is the most common cancer in men in the U.S. The cancer often doesn't have any symptoms, so the only way to find it early is through screening—either with a digital rectal exam or a blood test called a prostate-specific antigen (PSA) test. This decision tool focuses primarily on the PSA test, with or without the addition of other tests.

Note: This assessment is not a substitute for a visit with your healthcare provider.

Did you recently turn 50?

If you answered "yes." This is a good age to start a discussion about prostate cancer screening with your doctor if you are at average risk for developing the disease.

If you answered "no." If you're 50 or older, you and your doctor probably have had a discussion about screening for prostate cancer. If you're younger than 50, you may want to talk with your doctor if you have other risk factors.

Are you African American?

If you answered "yes." African Americans are at higher risk for prostate cancer. Talk with your doctor about screening at age 45.

If you answered "no." African Americans are at higher risk for prostate cancer, so they should talk with their doctors about prostate cancer screening at age 45.

Do you have a father, brother or son who was diagnosed with prostate cancer before age 65?

If you answered "yes." Having a first-degree relative with prostate cancer at an early age puts you at higher risk for the disease. You should start the conversation with your doctor about prostate cancer screening at age 45—or age 40, if you have more than one first-degree relative who had prostate cancer at an early age.

If you answered "no." Having a first-degree relative diagnosed with prostate cancer at an early age puts you at higher risk for the disease.

Do you have any symptoms of prostate cancer?

If you answered "yes." Prostate cancer doesn't always cause symptoms. But when it does, signs and symptoms can include:

• Difficulty starting a urinary stream.
• Frequent urination, especially at night.
• A weak or interrupted flow of urine.
• Blood in the urine or semen.

It's important to note that the symptoms of prostate cancer are similar to those of other prostate problems, such as benign prostatic hyperplasia.

If you answered "no." That's good. But sometimes prostate cancer doesn't cause symptoms. When it does, signs and symptoms can include:

• Difficulty starting a urinary stream.
• Frequent urination, especially at night.
• A weak or interrupted flow of urine.
• Blood in the urine or semen.

It's important to note that the symptoms of prostate cancer are similar to those of other prostate problems, such as benign prostatic hyperplasia.

Have you and your doctor talked about the benefits of prostate cancer screening?

If you answered "yes." OK. Just to review, there are several benefits to screening for prostate cancer:

• A normal PSA test may put your mind at ease.
• A PSA test may find cancer early before it spreads.
• Early treatment of prostate cancer can help some men avoid problems from cancer.
• Early treatment of prostate cancer may help some men live longer.

If you answered "no." There are several benefits to screening for prostate cancer. These include:

• A normal PSA test may put your mind at ease.
• A PSA test may find cancer early before it spreads.
• Early treatment of prostate cancer can help some men avoid problems from cancer.
• Early treatment of prostate cancer may help some men live longer.

Have you and your doctor discussed the potential harms of prostate cancer screening?

If you answered "yes." Good, because there are a few. For example:

• Your result could be a false negative. In other words, your test is normal but in fact missed signs of cancer.
• Your result could be a false positive. In other words, it suggests something is wrong when it isn't. This can create worry and stress.
• A false-positive PSA test may lead to an unnecessary prostate biopsy.
• A PSA test may find a cancer that is slow-growing and never would have caused you problems.
• Treatment of prostate cancer can cause harmful side effects. These include difficulty getting erections, leaking urine or problems with bowel function.

If you answered "no." Examples of potential harm from a PSA test include:

• Your result could be a false negative. In other words, your test is normal but in fact missed signs of cancer.
• Your result could be a false positive. In other words, it suggests something is wrong when it isn't. This can create worry and stress.
• A false-positive PSA test may lead to an unnecessary prostate biopsy.
• A PSA test may find a cancer that is slow-growing and never would have caused you problems.
• Treatment of prostate cancer can cause harmful side effects. These include difficulty getting erections, leaking urine or problems with bowel function.

Review

Your doctor is a great resource for information about prostate cancer screening. Together, you can decide what the right next step is for you.

Sources: American Cancer Society; American Society of Clinical Oncology; Centers for Disease Control and Prevention; National Cancer Institute; Urology Care Foundation; U.S. Preventive Services Task Force