Prostate Specific Antigen (PSA) Test

1. Prostate Cancer Slideshow Pictures
2. Medical Illustrations of the Prostate Image Collection
3. Men's Screening Tests Slideshow

• PSA Test Overview
• PSA Test Indications
• Prostate Cancer Risk Factors
• Prostate Cancer Screening Guidelines by Age
• PSA Test Preparation
• PSA Test Results
• PSA Test Interpretation and Accuracy

Prostate specific antigen (PSA) is a specific protein that is released by the prostate into the bloodstream. The prostate manufactures the liquid part of semen that helps transport sperm and also provides it with nutrition. The PSA test measures the amount of PSA in the blood. There are normal expected levels of PSA in the blood; levels might increase in patients with prostate cancer, benign prostatic hypertrophy (a noncancerous enlargement of the prostate), and prostate infection.

Historically, PSA has been used as a screening test for prostate cancer, but there is controversy as to whether it is an appropriate blood test to offer male patients. The question that has been asked is whether the benefits of detecting prostate cancers are countered by the complications that might develop due to treatment of a cancer that will not ultimately affect the patient.

The anecdote is that all men will develop prostate cancer if they live long enough. For that reason, in 2012, the United States Preventive Services Task Force (USPSTF) recommended against routine PSA screening for prostate cancer, referring to studies that showed that the screening did not decrease the death rate from the disease. An elevated PSA test result may also lead to unnecessary operations including prostate biopsies (tissue samples looking for cancer) and prostatectomy (removal of the prostate). Complications of the procedures included urinary incontinence and sexual impotence.

The American Urologic Association (AUA) has an alternative opinion. Urologists are the specialists that care for prostate cancer patients. They point out that prior to PSA testing, most prostate cancer was metastatic or had spread to other parts of the body at the time of diagnosis. After PSA screening began, prostate cancer was found much earlier before it had a chance to spread.

The American Cancer Society believes that the patient and health care professional should have an informed discussion of the risks and benefits of performing a PSA screening test and come to a shared decision.

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