Prostate specific antigen (PSA) test

The PSA test was first approved by the FDA in 1986 as a way to determine whether prostate cancer had been treated successfully and to monitor for its recurrence. However, PSA tests are now FDA approved for detection and are widely used to screen for the presence of prostate cancer. Clinical studies have demonstrated the following benefits of PSA testing:

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• An elevated PSA is the single best predictor of the presence of prostate cancer.
• PSA testing detects prostate cancer about five to 10 years earlier than digital rectal exams.
• Most cancers detected with PSA testing are curable.
• Serial PSA testing of a population leads to virtual elimination of advanced prostate cancer at the time of diagnosis.

However, it is not clear whether using the PSA test to screen for prostate cancer actually reduces the risk of death from the disease. In addition, some men with an elevated PSA do not have prostate cancer, and some of the cancers detected by the PSA test are too small or too slow growing to be life threatening. These men may undergo unnecessary diagnostic tests and treatments and may experience undue anxiety. Consequently, men should discuss the benefits and drawbacks of PSA testing with their physician before having their PSA levels measured.

This section includes information on:

• Testing guidelines
• Test results and cancer risk
• Refinements to the test