PSA test
PSA (Prostate Specific Antigen) is a protein, found in the blood. It is produced exclusively by the prostate, but not exclusively by prostate cancer. An elevated concentration of PSA can be related to the presence of prostate cancer, but may also point toward other benign conditions of the prostate, such as benign enlargement (BPH) or infection/inflammation. PSA may be artificially low after surgery for benign enlargement of the prostate (BPH) or with the use of drugs against this condition.
A word of caution: The risk calculator is based on the use of the Beckman Coulter Hybritech (Access) PSA assay. Recently, many of the other available assays were adjusted to a PSA standard of the World Health Organisation (WHO). These assays produce a 22% lower result. Your doctor should be aware of this and can help you to adjust your risk calculation accordingly.
Summary of the most important reasons for and against early detection
- If the result of the PSA test is favourable this will calm down my worries;
- The PSA test can help to find prostate cancer at an early stage and before it leads to complaints;
- If as a result of a positive PSA test I undergo successful treatment I may have a better chance of cure and may live longer;
- If the treatment is successful in an early stage, I may be spared the late symptoms of prostate cancer such as spread of the tumour to other parts of my body (metastases).
- Screening has been shown to lower prostate cancer mortality by 20 – 27% in men age 55 – 69. Considering the potential risks advice by health professionals is still considered mandatory.
- I may miss the chance of cure and of avoiding prostate cancer death.
- If my PSA value is elevated and further study does not show prostate cancer I will have undergone medical testing for nothing and this will have caused unnecessary anxiety;
- The PSA test can miss prostate cancer. After a normal result I may feel relieved for no good reason or may still remain worried;
- An elevated PSA test may detect a slow growing tumour which would otherwise never have given me any trouble;
- I may be confronted with the possible complications of the treatment of prostate cancer.
