Prostate cancer remains a significant concern in my practice, which is why I emphasize the importance of early detection. The American Cancer Society estimates there will be nearly 300,000 new cases of prostate cancer and about 35,000 deaths in 2024.

One vital tool in this quest to diagnose and treat this common cancer is prostate-specific antigen, or PSA, testing, which is a simple blood test offering valuable insights into prostate health. By the age of 50, men should be having the test done annually. If you have a family history, have risk factors, or if you are Black, you may need to start as early as age 40.

What is prostate-specific antigen testing?

Prostate-specific antigen testing serves as a cornerstone in the early detection of prostate cancer. When combined with other diagnostic tests and clinical assessments, it aids in identifying prostate cancer in its early stages, when treatment outcomes for prostate cancer surgery and radiation have the best odds for cure.

Regular PSA screenings are particularly crucial for high-risk individuals, such as those with a family history of prostate cancer or advanced age. The blood test is also essential for the average man during his routine annual checkup with his primary care doctor.

What else can affect PSA levels?

Conditions such as an enlarged prostate, recent sexual activity or prostate infections can all contribute to elevated PSA levels, potentially leading to unnecessary alarm. By considering these factors alongside PSA test results, health care providers can provide more informed guidance and avoid unnecessary interventions.

Going beyond PSA for screening

Prostate-specific antigen testing has also evolved beyond its traditional bounds, with advancements in molecular urine and blood tests and imaging technology.

Blood and urine-based tests can now pinpoint specific genetic markers associated with prostate cancer, providing insights into each patient’s unique risk profile.

When combined with traditional PSA testing, these tests offer an even more comprehensive picture of a patient’s prostate health and cancer risk. These tests in combination with the initial PSA can help us determine who may benefit most from further investigation such as a prostate biopsy.

Prostate MRI technology offers a detailed, high-definition view of the prostate gland. It enables us to identify suspicious lesions within the prostate gland that could harbor prostate cancer. These “hot spots” are then targeted using MRI fusion technology in which the MRI images are fused to the live ultrasound images during a prostate biopsy. The use of this imaging tool allows for more accurately detecting cancer during a prostate biopsy.

Together, these additional tests can increase our ability to detect prostate cancer, ultimately leading to more effective and personalized treatments.

More prostate cancer testing and detection for Black men

Recent research and guidelines from the Prostate Cancer Foundation highlight a significant update in prostate cancer screening for Black men. Recognizing their heightened risk, the guidelines recommend initiating baseline PSA testing between ages 40 and 45, earlier than current recommendations from other organizations. Regular screenings, preferably annually, should continue until at least age 70. These updates aim to address disparities in prostate cancer outcomes among Black men, offering essential lifesaving screening recommendations.

Lowering the recommended age for baseline PSA testing in Black men could reduce prostate cancer deaths by about 30% without significantly increasing overdiagnosis rates, according to recent findings. Doing so emphasizes the importance of tailored screening approaches for high-risk populations, particularly Black men, who are about two times more likely to be diagnosed with and die from prostate cancer than White men.

Proactive steps toward prostate health for all men

The PSA test remains a critical tool in prostate cancer detection, offering men an opportunity for early intervention and improved outcomes. Staying informed about updates in screening guidelines and understanding individual risk factors is vital. By prioritizing proactive health care and engaging in open discussions with health care providers, men can take charge of their prostate health and contribute to reducing the burden of prostate cancer in our communities.

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