Prostate Screening (PSA) Test

A prostate screening test is also known as the prostate-specific antigen (PSA) test. This is a blood test used to screen for prostate cancer in men, according to the Mayo Clinic. The test specifically measures the level of PSA, a protein produced by the prostate gland, in the blood and is usually included during men’s health exams.

How is a prostate exam (PSA test) done?

A PSA test is a simple blood test that is usually done in a healthcare provider's office or laboratory. During this test, a healthcare professional or lab technician will draw a small amount of blood from a vein in your arm or hand, using a needle. The blood sample will then be sent to the laboratory for screening.

There is no preparation needed for a PSA test, however, if you are getting your PSA checked along with other blood tests, you may need to fast from eating or drinking anything except water for several hours before the test. Your doctor can give you specific instructions on the preparation when you schedule your test.

How is a digital rectal exam (DRE) done?

During a digital rectal exam (DRE), your healthcare provider will insert a gloved, lubricated finger into your rectum to feel for any abnormalities in your prostate gland. Here's what you can expect during a DRE, according to the Mayo Clinic:

• Preparation: There is typically no preparation needed for a DRE, but you may be asked to empty your bladder or bowels before the exam.
• Positioning: You will likely be asked to lie on your side with your knees pulled up to your chest, or to bend over a table or exam table.
• Exam: Your healthcare provider will insert a gloved, lubricated finger into your rectum and gently feel your prostate gland. They will check for any lumps, bumps, or other abnormalities in the size, shape, or texture of your prostate.
• Discomfort: The exam may cause some discomfort or pressure, but it should not be painful. If you feel any pain, let your healthcare provider know.
• Completion: Once the exam is complete, your healthcare provider will remove their finger and dispose of the gloves. They will discuss any findings or recommendations with you, or schedule additional testing if needed.

It's important to discuss any concerns or questions about the DRE with your healthcare provider. While the exam can be uncomfortable or embarrassing for some men, it is a routine and important part of prostate cancer screening.

When should I start getting screened for prostate cancer?

The American Cancer Society recommends that you begin prostate cancer screenings at age 50 if you have average risk, age 45 for men at greater risk, and age 40 for men at high risk.

A greater risk is defined as being African American or having an immediate relative (a father, or brother) who was diagnosed with prostate cancer at an early age (younger than 65).

High risk is men with more than one close relative who had prostate cancer at an early age, notes the American Cancer Society.

PSA Test Results

It takes one to two weeks for PSA test results, according to the Mayo Clinic. There are some rapid PSA tests available in some doctor's offices that offer results in as little as 15 minutes. Not all healthcare locations will have rapid PSA tests, but most will have standard PSA testing available.

Understanding your PSA test results

According to the Mayo Clinic and American Cancer Society, your PSA results will show either “normal” or “elevated”.

Normal PSA levels

A PSA level below 4 nanograms per milliliter (ng/mL) is considered normal for most men, according to the ACS. However, some healthcare providers may consider PSA levels up to 2.5 ng/mL to be normal for men under 50, or up to 4.5 ng/mL to be normal for men between 50 and 60 years old.

Elevated PSA levels

PSA levels above the normal range may indicate the presence of prostate cancer or other prostate conditions, according to the Mayo Clinic. However, not all men with elevated PSA levels have prostate cancer, and some men with prostate cancer may have normal PSA levels.

If your PSA level is elevated, your healthcare provider may recommend additional testing, such as a digital rectal exam (DRE) or a prostate biopsy, to determine if you have prostate cancer or another prostate condition, according to the Mayo Clinic.

Can a PSA be wrong?

PSA tests can sometimes produce false positive or false negative results, which means that the test can indicate the presence of prostate cancer when none exists (false positive) or miss the presence of cancer when it does exist (false negative). It is important to combine PSA testing with a physical exam and detailed medical history for the most accurate results.

Finding a PSA test

PSA testing can be found at most healthcare facilities and walk-in laboratories. You can schedule an appointment at a walk-in clinic, urgent care, or family physician for a PSA test. If you need help finding a doctor or lab test, you can use Solv’s directory to find the closest one to you.

Can I do a PSA test at home?

There are now at-home PSA tests available for purchase online or from a drug store. It is important to note that while at-home PSA tests may be convenient, they may not be as accurate as tests performed in a healthcare setting.

Additionally, if you are experiencing symptoms of prostate cancer, or you have a greater risk of developing prostate cancer, you should be tested in a healthcare setting. It is also important to now that the DRE is usually done in conjunction with a PSA test

Cost of a PSA test

The average cost of PSA testing in the USA can vary widely depending on the type of test, location, and healthcare provider. Additionally, health insurance coverage can also play a role in the cost of testing. Some insurance plans cover the cost of preventive screenings and tests, while others may require a copay or coinsurance.

The average range of PSA testing in the US is between $27 and $49, according to FindLabTest.com

More about prostate cancer

What are the symptoms of prostate cancer?

In its early stages, prostate cancer often does not cause any noticeable symptoms, according to the American Cancer Society. As prostate cancer grows, it may cause some of the following symptoms:

• Changes in urination, such as difficulty starting or stopping urination, weak urine flow, or the need to urinate more frequently, especially at night
• Blood in urine or semen
• Erectile dysfunction
• Advanced prostate cancer can cause pain or discomfort in the prostate gland, lower back, hips, or other parts of the body.

It's important to note that these symptoms can be caused by other prostate conditions, such as prostatitis (inflammation of the prostate) or benign prostatic hyperplasia (enlarged prostate), and do not necessarily indicate prostate cancer.

However, if you are experiencing any of these symptoms, it's important to discuss them with your healthcare provider to determine the cause and to receive appropriate treatment if needed.