Our Prostate Cancer Screening Guidelines
Our doctors recommend the following screening guidelines:
For men in the general population, prostate cancer screening -- using both PSA testing and a DRE -- should begin at age 50. In high-risk groups such as African-American men and men with a family history of prostate cancer, prostate cancer screening -- using both PSA testing and DRE -- should begin at age 40.
If a man screened with DRE receives an abnormal result, regardless of PSA level, he should be referred to a urologist for further testing.
To balance the influence of age on PSA levels, the following age-specific PSA level cut-offs should be considered:
- Greater than or equal to 2.5 ng/mL for men up to age 49
- Greater than or equal to 3.5 ng/mL for men aged 50 to 59
- Greater than or equal to 4.0 ng/mL for men aged 60 and older.
Men with values outside their age-allowed targets should be considered as candidates for prostate biopsy.
For those men being screened for PSA velocity, a PSA velocity of greater than or equal to 0.75 ng/mL per year should necessitate a prostate biopsy -- even if the PSA level is in the normal range.
Again, it is important to remember that the evidence supporting the usefulness of prostate cancer screening is suggestive but not definitive, and to note the potential harms (i.e. anxiety, biopsy complications) that may result from prostate cancer screening. As always, the subject of prostate cancer screening should be discussed with your physician.
