Screening Guidelines
American Cancer Society (ACS)
The American Cancer Society believes that health care professionals should offer the prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) yearly, beginning at age 50, to men who have at least a 10 year life expectancy. Men at high risk, such as African Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65) should begin testing at age 45.

Information should be provided to all men about what is known about the pros and cons of early detection and treatment of prostate cancer. These facts can assist men to make an informed decision about screening.

The National Cancer Institute (NCI)
There is insufficient evidence to conclude if screening for prostate cancer with PSA or digital rectal exam reduces death from prostate cancer. Screening tests are able to detect prostate cancer at an early stage, but it is not clear if this earlier detection and earlier treatment leads to any change in the outcome of the disease.

The U.S. Preventative Services Task Force (USPSTF)
The U.S. Preventive Services Task Force concludes that the evidence is insufficient to recommend for or against routine screening for prostate cancer using prostate specific antigen (PSA) testing or digital rectal examination.

Exams and Test Explained
For a digital rectal exam, the doctor gently inserts a gloved, lubricated finger into the rectum and feels the prostate for hard or lumpy areas.

The Prostate Specific Antigen (PSA) blood test measures the level of a certain protein. In some men with prostate cancer, this level will rise, alerting the doctor that there may be a tumor. However, a normal PSA level does not rule out cancer. Also, an elevated level may be due to a benign condition.

Symptoms to Report to Your Doctor

• A need to urinate frequently, especially at night
• Difficulty starting urination or holding back urine
• Inability to urinate
• Weak or interrupted flow of urine
• Painful or burning urination
• Painful ejaculation
• Blood in urine or semen
• Frequent pain or stiffness in the lower back, hips or upper thighs

Testicular Cancer
The performance of testicular self-examination is controversial. No studies have ever been done to determine the effectiveness of testicular self-exam or clinical exam by a health care professional, in reducing the mortality from testicular cancer. Ask your doctor if you should perform self-exam or if you should have clinical testicular examinations.

Symptoms to Watch For

• A lump in either testicle
• An enlargement of a testicle
• A feeling of heaviness in the scrotum
• A dull ache in the lower abdomen or the groin
• A sudden collection of fluid in the scrotum
• Pain or discomfort in a testicle or in the scrotum
• Enlargement or tenderness of the breasts

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For more information

Contact the Cancer Information Service, 800-237-1225.