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PSA and Digital Rectal Exam Print
Recommendation for Screening
Age:
How often:
40-50
5 years
Age:
How often:
50-74
Annual
Gender: Male

Note:
Annual exam recommended for age range 40-50 if:
  • Family history
  • PSA > 0.6
  • Race: African American

1. What is this test?

The prostate specific antigen test is a blood test to measure the level of prostate specific antigen, a protein marker for prostate cancer. The digital rectal examination is a test done by the doctor to examine the size and contour of the prostate. There is still controversy about the optimal time to begin prostate screening, and even questions about overall efficacy of screening. People with other serious illnesses may not benefit from prostate screening, depending on life expectancy for that condition.


2. Why do I need this test?

These are both done to screen for prostate cancer. In the United States, over 32,000 men were predicted to die of prostate cancer in 2010. About 217,000 new cases were predicted for 2010. There is some controversy about whom to screen and how often to screen. This is because of the complexity of understanding the potential risks and benefits of diagnostic and treatment options. Extensive research is being done in this arena and you can discuss this with your physician.


3. How is this test done?

Like most blood tests, the prostate specific antigen is measured in a sample of blood taken from a vein in your hand or arm. The digital rectal exam is done by your doctor and involves insertion of a gloved finger into the rectum to feel the prostate gland. Since this test is also done for colorectal screening, the rectum can also be examined for abnormal growths and a sample of stool can be taken to look for blood.


4. Are there any special instructions for this test?

You will likely be instructed to avoid ejaculation within 48 hours of testing.


5. Risk factors
  • Age >/= 65
  • Family history, especially father or brother with prostate cancer
  • African American
  • Possibly high fat diet
  • Elevated testosterone
  • Farmers
  • Cadmium exposure
  • Tire plant workers
  • Painters


Citations
  1. "Preventive Screening Tests and Immunizations." U.S. Department of Health and Human Services. March 2011. http://www.womenshealth.gov/prevention/men/.
  2. "The Prostate-Specific Antigen (PSA) Test: Questions and Answers." National Cancer Institute. U.S. National Institutes of Health. March 2009. www.cancer.gov/cancertopics/factsheet/Detection/PSA/.
  3. "Estimated New Cancer Cases and Deaths by Sex, United States, 2010." CA A Cancer Journal for Clinicians: Cancer Statistics, 2010. July 2010. http://caonline.amcancersoc.org/cgi/content/full/caac.20073v1/TBL1.
  4. "Prostate Cancer Early Detection." NCCN Practical Guidelines in Oncology-v.2.2010. National Comprehensive Cancer Network. 2010. Requires registration and log-in. www.nccn.org/professionals/physician_gls/PDF/prostate_detection.pdf.
  5. "Digital Rectal Exam." Medline Plus. Medical Encyclopedia. A Service of the U.S. National Library of Medicine and the National Institutes of Health. November 2009. www.nlm.nih.gov/medlineplus/ency/article/007069.htm.
  6. "Prostate Cancer." Medline Plus. Medical Encyclopedia. A Service of the U.S. National Library of Medicine and the National Institutes of Health. September 2010. www.nlm.nih.gov/medlineplus/ency/article/000380.htm.
  7. "Screening for Prostate Cancer." AHRQ. U.S. Department of Health and Human Services. August 2008. http://www.uspreventiveservicestaskforce.org/uspstf/uspsprca.htm.

Created: 7/2/2007
Last Modified: 4/19/2011
 
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