How early is prostate cancer screening?

Article by Specialist Doctor I Nguyen Thi Minh Thuyen - Laboratory Department - Vinmec Danang International Hospital

To detect cancer before symptoms appear, the current method is screening. However, according to studies, the benefits of prostate cancer screening are unclear, and it is not clear whether the benefits outweigh the risks for most men. By understanding the pros and cons of prostate cancer screening, you can make the right decision for you.
Prostate cancer can often be found early thanks to:
Tests for prostate-specific antigen (PSA) blood levels. Finger rectal examination of the prostate gland. If the results of either of these tests are abnormal, your doctor may recommend a biopsy of your prostate to see for sure if cancer is present.

Certain tests or imaging tests will be used when screening for prostate cancer.
2.1 Prostate-specific antigen in the blood (PSA) Normally, most men have a blood PSA reading < 4 ng/mL. However, a level below 4 does not guarantee cancer-free. As prostate cancer develops, PSA levels are usually > 4 ng/mL. PSA between 4 and 10 ng/mL: About 25% chance of getting prostate cancer PSA greater than 10 ng/mL: More than 50% chance of getting prostate cancer -Factors can raise levels PSA:
Prostate enlargement Old age Prostatitis Ejaculation (this is why doctors often suggest men abstain from ejaculation for 1-2 days before a PSA test) Cycling (some studies show found that cycling can increase PSA levels for a short time, possibly because the chair puts pressure on the prostate) Certain urological procedures (eg, Prostate Biopsy or cystoscopy) X-ray, manual rectal examination may increase PSA levels for a short time) Certain medications (male hormone testosterone or other drugs that increase testosterone levels) -Factors that may decrease PSA levels (even with prostate cancer):
5-alpha reductase inhibitors: Finasteride (Proscar or Propecia) or Dutasteride (Avodart), used to treat benign prostatic hyperplasia paralysis or urinary symptoms, which can lower PSA levels. These drugs may also affect the risk of prostate cancer. Some blends sold as supplements can falsify test results and mask high PSA levels. Therefore, when testing for PSA, patients need to let their doctor know if they are taking supplements. Other medications with long-term use of certain medications, such as aspirin, statins (a cholesterol-lowering drug), and thiazide diuretics (such as hydrochlorothiazide) can lower PSA levels. For men being screened for prostate cancer, lowering PSA isn't always helpful. When factors lower PSA from abnormal to normal levels, cancer can also be left undetected. Therefore, it's a good idea to talk openly with your doctor about anything that might be affecting your PSA levels. 2.2 Digital rectal exam (DRE) The doctor inserts a gloved and lubricated finger into the rectum to feel and detect any swelling or hard areas on the prostate that may be cancer. The exam is quick and painless, but it can also be uncomfortable, especially for someone with hemorrhoids. The DRE is less effective than the PSA blood test at detecting prostate cancer, but it also helps detect cancer in men with normal PSA levels. Therefore, DRE is considered as part of prostate cancer screening.

If the test shows a higher-than-normal level of PSA in your blood at first, it doesn't mean you have prostate cancer. Many men with higher than normal PSA levels do not have cancer. Your doctor may advise you of one of the following options for further testing:
Recheck PSA Do more tests Prostate biopsy The following factors may influence the choice of screening modality. fit:
Your age and general health Chances of you having prostate cancer Are you comfortable waiting or doing other tests -Redo the PSA test:
The PSA level in the blood can be changes over time, so some doctors recommend that patients repeat the test 1 month later or possibly longer if the initial PSA results are abnormal This may be a reasonable option if the PSA level is from 4 to 7 ng/mL With a PSA level of more than 7ng/mL, your doctor will most likely advise you to have other tests or a prostate biopsy -Do other tests:
Manual rectal exam (DRE) , if not already done Diagnostic MRI or transrectal ultrasound -Prostate Biopsy:
A biopsy is the only way to know for sure if a person has prostate cancer or not. Prostate tissue is technically processed and observed under a microscope. Biopsy results can also help predict how likely the cancer will grow and spread.

The American Cancer Society (ACS) recommends that men make their own decisions about whether or not to have prostate cancer screening based on the potential risks and benefits of screening.
Factors that influence screening decisions:
50-year-old men have an average risk of prostate cancer and are expected to live for at least 10 years 45-year-old men have an increased risk of prostate cancer high, including African-Americans and those whose father or brother was diagnosed with prostate cancer under the age of 65. Men 40 years old have a higher risk, having 2 or more men with a father or brother develop prostate cancer at a young age. If I have been screened and have not found prostate cancer, how often should I be screened again? The timing of follow-up screening depends on the results of the PSA blood test:
PSA < 2.5 ng/mL: Retest every 2 years PSA > 2.5 ng/mL: Annual screening recommended Prostate cancer usually grows slowly, people without symptoms of prostate cancer who do not expect to live an extra 10 years should not be tested because screening at this time does not bring much benefit. When making screening decisions, overall health is more important than age.
With modern and synchronous automatic and semi-automatic testing equipment of famous brands such as Beckman Coulter, Roche, Thermo, Siemens, Biomeriux... Laboratory Department of Vinmec Da International General Hospital Nang undertakes biochemical tests - immunology, hematology - blood transfusion, microbiology and pathology from basic to advanced and specialized. In particular, the Faculty has a microbiology laboratory that meets the standards of a Level II Biosafety Laboratory with a pressurization system and a HEPA filter system for the entire area of ​​the rooms. The tests at Vinmec Da Nang are performed according to standard procedures, strict quality control, accurate results with fast response time, a reliable basis for doctors to choose treatment regimens. optimal for the patient.

Reference article source: American Cancer Society