Screening for Prostate Cancer Health Article

What is screening?

Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormaltissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.

Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend who should be screened for cancer, which screening tests should be used, and how often the tests should be done.

It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms. Screening tests may be repeated on a regular basis.

If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.

Refer to the following PDQ summaries for information about prevention, diagnosis, and treatment of prostate cancer:

• Prevention of Prostate Cancer

• Prostate Cancer Treatment

General Information About Prostate Cancer

Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate.

The prostate is a gland in the male reproductive system located just below the bladder (the organ that collects and empties urine) and in front of the rectum (the lower part of the intestine). It is about the size of a walnut and surrounds part of the urethra (the tube that empties urine from the bladder). The prostate gland produces fluid that makes up part of semen.

Prostate cancer is found mainly in older men. As men age, the prostate may get bigger and block the urethra or bladder. This may cause difficult urination or problems with sexual function. The condition is called benign prostatic hyperplasia (BPH), and although it is not cancer, surgery may be needed to correct it. The symptoms of benign prostatic hyperplasia or of other problems in the prostate may be similar to symptoms of prostate cancer.

Prostate cancer is the most common nonskin cancer among men in the United States.

Although the number of men with prostate cancer is large, most men diagnosed with this disease do not die from it. In black men, however, prostate cancer is usually more advanced and they are more likely than white men to die from the disease.

Age, race, and family history of prostate cancer can affect the risk of developing prostate cancer.

Anything that increases a person's chance of developing a disease is called a risk factor. Risk factors for prostate cancer include the following:

• Being 50 years of age or older.

• Being black.

• Having a brother, son, or father who had prostate cancer.

• Eating a diet high in fat or drinking alcoholic beverages.

Prostate Cancer Screening

Tests are used to screen for different types of cancer.

Some screening tests are used because they have been shown to be helpful both in finding cancers early and decreasing the chance of dying from these cancers. Other tests are used because they have been shown to find cancer in some people; however, it has not been proven in clinical trials that use of these tests will decrease the risk of dying from cancer.

Scientists study screening tests to find those with the fewest risks and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) decreases a person's chance of dying from the disease. For some types of cancer, finding and treating the disease at an early stage may result in a better chance of recovery.

There is no standard or routine screening test for prostate cancer.

Screening for prostate cancer is under study and there are screening clinical trials taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Cancer.gov Web site.

Tests that may detect (find) prostate cancer are being studied:

Digital rectal exam

Digital rectal exam (DRE) is an exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel the prostate for lumps or anything else that seems unusual.

Prostate-specific antigen test

A prostate-specific antigen (PSA) test is a test that measures the level of PSA in the blood. PSA is a substance made mostly by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection or inflammation of the prostate or benign prostatic hyperplasia (BPH; an enlarged, but noncancerous, prostate).

Scientists at the National Cancer Institute are studying the combination of PSA testing and digital rectal exam as a way to get more accurate results from the screening tests.