I am 55. Can the PSA test lead to overdiagnosis?

Question

Hello doctor,

I am 55 years old, and I have been considering prostate cancer screening lately. I have heard about the prostate-specific antigen (PSA) test, but I am concerned about the risk of overdiagnosis and unnecessary treatments. I want to make an informed decision about my health.

Can you provide some insights into the benefits and limitations of the PSA test and how to navigate the potential risks of overdiagnosis?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

A prostate-specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.

As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others. PSA levels can also be affected by certain medical procedures, medications, an enlarged prostate, or a prostate infection. As doctors, we interpret, knowing the history and genetic risks, to determine whether you are suffering from inflammatory conditions or cancer.

Watchful waiting is the recommended strategy for patients with BPH (benign prostate hyperplasia) who have mild symptoms (International Prostate Symptom Score/American Urological Association Symptom Index [IPSS/AUA-SI] score ≤7) and for those with moderate-to-severe symptoms (IPSS/AUA-SI score ≥8) who are not bothered by their symptoms and are not experiencing complications of BPH. In those patients, medical therapy does not improve their symptoms and/or quality of life (QOL).

I hope you find this information helpful.

Thank you.