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Prostate Cancer Screening

The prostate is a gland that lies just below the bladder. It is part of the male reproductive system. Problems with the prostate become more common as a man ages. These problems include prostate cancer, a common cancer in men. This cancer can often be cured or controlled, especially if it is found and treated early. Screening tests can often help detect prostate cancer before it causes any symptoms. But testing can also lead to problems, such as finding some cancers that might never need to be treated, so not all doctors agree on whether all men should be screened.

Prostate Cancer

Cancer is an uncontrolled growth of abnormal cells. These cells form in one area. They can then spread throughout the body. Prostate cancer causes no symptoms in its early stages. If you have urinary symptoms, these are more likely to be due to another health problem.

Cross section side view of male pelvis. Healthcare provider's gloved finger is inserted in rectum to feel prostate through rectal wall.

Risk Factors for Prostate Cancer

The things that can increase a man’s chance of developing prostate cancer are called risk factors. These include:

  • Age. As you grow older, your risk of developing prostate cancer increases.

  • Family history. If your father or brother has had prostate cancer, your risk of developing it is higher.

  • Race. African-American men are more likely than other men to develop prostate cancer. They are also more likely to die of prostate cancer than other men with this disease.

Screening for Cancer

Screening for prostate cancer can help check if you have cancer. Talk with your health care provider about the pros and cons of  regular screening starting at age 50 or earlier if you are at higher risk. Screening tests often include a digital rectal exam (DRE) and a prostate specific antigen (PSA)test.

Health History and DRE

Tell your health care provider about:

  • Any health problems and symptoms you have.

    Any family members who have had prostate cancer or other related health problems.

  • Medications, herbs and supplements that you take.

  • Any problems with urination or symptoms of urinary tract infection.

Your health care provider may perform a DRE. This involves gently inserting a lubricated gloved finger into the rectum. Because the prostate is next to the rectum, many prostate problems can be found with this exam.

The PSA Test

PSA is a protein produced by prostate tissue. Your PSA level can be measured with a blood test. A high or rising PSA level may suggest that you have prostate cancer or another, non-cancerous prostate problem. A lower PSA level suggests that cancer is less likely. Your health care provider may also check:

  • The ratio of free PSA (PSA that is not bound to a certain protein in the blood) to total PSA.

  • The PSA velocity. This is how fast the PSA level is rising over time.

  • The PSA density. This is the relation of the PSA level to the size of the prostate.

Many factors can affect PSA levels. Some, such as age, having an enlarged prostate, or prostate cancer, are ongoing. Others, such as having a prostate infection or recent sex, only affect PSA levels for a short time. Your HCP can explain how these factors may affect the timing of the PSA test and your results.

Further Testing

Problems found with DRE may not be tumors. And a high PSA level does not always mean cancer. More tests may need to be done. After looking at the results of your screening tests, your HCP may recommend other tests.


This test involves taking small samples of tissue from the prostate using a thin needle. An imaging method, such as ultrasound, is used to help guide the needle to the correct place in the prostate. The tissue samples are then tested in a lab for cancer cells.

Imaging Tests

If cancer is found, imaging tests can help check for its spread. Bone scans (X-rays) can check whether cancer has spread to bones. CT and MRI scans can detect tumors in bones and soft tissues.


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