What Type Of Screening Uses The Psa Blood Test

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Refinements of the prostate-specific antigen (PSA) test have been developed to reduce the number of false positive results (or a chance that a positive test result is not really due to cancer). These include measuring the proportion of free PSA, the density of PSA, and the velocity of PSA changes. Not all authorities agree on how to use these additional PSA tests. If your PSA is found to be high, ask your primary healthcare practitioner to discuss your cancer risk and the possible use of other evaluations of PSA before having a biopsy.

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What are some of the limitations and potential harms of the PSA test for prostate cancer screening? Detecting prostate cancer early may not reduce the chance of dying from prostate cancer. When used in screening, the PSA test can help detect small tumors that do not cause symptoms. Finding a small tumor, however, may not necessarily reduce a man’s chance of dying from prostate cancer. Many tumors found through PSA testing grow so slowly that they are unlikely to threaten a man’s life.

Detecting tumors that are not life threatening is called “overdiagnosis,” and treating these tumors is called “overtreatment.” Overtreatment exposes men unnecessarily to the potential complications and harmful side effects of treatments for early prostate cancer, including surgery and radiation therapy. The side effects of these treatments include urinary incontinence (inability to control urine flow), problems with bowel function, erectile dysfunction (loss of erections, or having erections that are inadequate for sexual intercourse), and infection.

In addition, finding cancer early may not help a man who has a fast-growing or aggressive tumor that may have spread to other parts of the body before being detected. The PSA test may give false-positive or false-negative results. A false-positive test result occurs when a man’s PSA level is elevated but no cancer is actually present. A false-positive test result may create anxiety for a man and his family and lead to additional medical procedures, such as a prostate biopsy, that can be harmful.

Possible side effects of biopsies include serious infections, pain, and bleeding. Most men with an elevated PSA level turn out not to have prostate cancer; only about 25% of men who have a prostate biopsy due to an elevated PSA level actually are found to have prostate cancer when a biopsy is done (2). A false-negative test result occurs when a man’s PSA level is low even though he actually has prostate cancer.

False-negative test results may give a man, his family, and his doctor false assurance that he does not have cancer, when he may in fact have a cancer that requires treatment.

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