There are two main tests that doctors use to test for prostate cancer. Both are easily performed, harmless, and very accurate in diagnosing prostate cancer, especially when both tests are performed together. Both tests should be performed on all men over the age of 50, but many men should begin annual screening at an earlier age, either 40 or 45, if they have combined risk factors. An African American man whose father died from prostate cancer, for example, should begin routine testing at 40 or 45.
The most common test for prostate cancer is called the digital rectal exam (DRE). Any doctor can perform this test; the doctor uses a lubricated, gloved finger to feel the prostate through the rectal wall. This allows the doctor to manually feel any tumors or cancerous growths on the prostate. The test is painless, and takes less than 10 seconds to perform.
The second common prostate cancer test is the prostate-specific antigen test (PSA test). The prostate naturally produces hormones and fluids, and this test measures levels of the prostate-specific antigen in the blood. When prostate cancer begins to develop, the cancerous cells produce this antigen at a much higher rate than normal cells do, so high levels of PSA in a man's blood suggest that cancerous cells may be present. The average level of PSA is 4 ng/ml, though some professionals think lowering this level to 2.5 ng/ml would allow doctors to catch more cases of early prostate cancer.6 The test is performed by a blood draw.
It is important for every man over the age of 50, and for men with combined risk factors to get screened for prostate cancer annually. While some doctors feel that it is unnecessary to screen all men, there is much research showing the benefits of routine screening. Men who are screened annually see a reduced mortality rate, because it allows the doctor to catch the cancer in its earlier stages.7 As with many diseases, prostate cancer is much easier to treat and survive when diagnosed early on.
Whether or not a man decides to be tested is essentially up to him, but every man should have the discussion with his doctor. For many men, decision making guides can be helpful in making an informed decision about whether or not to be screened.
6. Lab Advisor, "Prostate Specific Antigen Measurement." MICROMEDEX Healthcare Series 18 Nov 2008 <http://www.thomsonhc.com/hcs/librarian/PFDefaultActionEd/pf.PrintReady>.
7. Aus, Gunnar. "Prostate Cancer Screening Decreases the Absolute Risk of Being Diagnosed with Advanced Prostate Cancer - Results from a Prospective, Population-Based Randomized Controlled Trial." European Urology 51(2007): 659-664.