When and how often do you recommend taking the PSA test for prostate cancer screening?

Answered February 01, 2011 17:37. The confusion is reflective of different recommendations based on different biases and goals. It is misleading to think of prostate cancer as a disease that never harms anyone. Prior to PSA screening, 70% of prostate cancers were not detected until pain or other sever symptom of advanced disease occurred. Currently I rarely see advanced disease. Still, in the US each year, over 35,000 men dye from prostate cancer. Many more are left impotent and weak with increased risk of heart disease by the hormone treatment of advancing cancer.

I had my first PSA at 50 and recommend that for the general public. However, you must be able to be patient in the interpretation of PSA. This is where the controversy should be focused.

In African Americans or in cases with a family history of prostate cancer I recommend age 40 or earlier to start screening, These are 2 situation where earlier and more aggressive disease occurs more frequently.

When you get your PSA, keep your own chart of annual changes. The trend is more important than the absolute measure but non-specialists may not understand. The Radiation Oncology Department at UCSF (your city) is one of the best I could recommend if an issue arises.

Best wishes,
hmj