Prostate Screening

Screening for Prostate Cancer

WakeMed’s urology team follows the American Urological Association (AUA) guidelines as follows for prostate screenings:

• PSA screening should begin for men at age 40 years who are at increased risk of developing prostate cancer. Risk factors include black ancestry, germline mutations or strong family history of prostate cancer.
• PSA screening should begin between the age of 45-50 years for men without increased risk factors.
• For men over the age of 69 years, patients should engage in shared decision making with their physician on whether to continue PSA screening.

Generally, the AUA recommends men get screened every two years. Ask your Primary Care Provider, to discuss screening options and ensure your prostate health is on track.

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What to Expect from a Prostate Cancer Screening

In most cases, screening for prostate cancer begins with a a prostate-specific antigen (PSA) test, which acts as the first line of defense. A digital rectal exam (DRE) may also be performed. Together, these tests can provide your physician with information on your prostate help and refer to a urologist if needed.

• Prostate-specific antigen (PSA) test:  This simple blood test checks the levels of PSA found in your blood. It’s not a definitive test, though, since an elevated PSA level just increases your chance of having prostate cancer. There is no set PSA number that tells us for certain that a man does or doesn’t have prostate cancer. Normal" PSA levels depend on the patients age, so discussion with your doctor is essential. For example, for a man under 50, a normal PSA should be less than 2. For men between 50-70, A 'normal" PSA should be between 2-4. For men over 70, it depends on many factors and the previous trend of information to determine when additional evaluation is needed. It is also important to know that recent sexual activity, urinary tract infection, or chronic prostate inflammation can all affect the PSA.
• Digital rectal exam (DRE): In this exam, your urologist will briefly insert a gloved, lubricated finger into the rectum to check the prostate for potential abnormalities such as lumps, bumps or hard areas that could indicate cancer.

Abnormal results for either of these tests don’t necessarily confirm that you need treatment for prostate cancer. Because prostate cancer is a relatively slow-growing cancer, it’s not always treated right away. Depending on your health and other risk factors, your urologist may recommend either further testing (such as a biopsy) or a “watchful waiting” approach that may involve future, more frequent screening.

If you’re facing concerning numbers from a PSA screening or a prostate cancer diagnosis, our team at WakeMed Urology, is here to guide you with options and expert care.

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Hear from Dr. Hannah McCloskey with WakeMed Urology as she discusses current prostate screening guidelines and what to expect.