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PSA - Risks

Alternative Names

Prostate-specific antigen; Prostate cancer screening test 

What the risks are:

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

  • Excessive bleeding
  • Fainting or feeling light-headed
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)

Special considerations:

Measuring PSA levels can increase the chance of finding prostate cancer when it is very early.

However, the value of PSA screening for prostate cancer is controversial. There is not a single answer that fits all men. Before having the test, it is best to discuss both the reasons to have and the reasons not to have a PSA test with your doctor.

Some questions you may ask your doctor when discussing having a PSA test include:

  • What does an abnormal PSA test mean? Does it mean you have cancer?
  • If the PSA test is abnormal, what other tests will be needed? Will you need a biopsy?
  • What are your risk factors for prostate cancer? Does that change whether you should have a PSA test? What is the best age to start having a PSA test?
  • What are the benefits and risks of finding prostate cancer when it is very early?

If a man chooses to be tested, the PSA is most often done every year to screen:

  • Men ages 40 - 75
  • Men with a family history of prostate cancer (especially a brother or father) and African-American men, who should think about starting around age 40 - 45. This is because they have a higher chance of developing prostate cancer.

PSA testing is not recommended for screening men over age 75.

There are different recommendations about screening tests for prostate cancer. For more information, check with:

  • American Urological Association
  • National Comprehensive Cancer Network
  • American Cancer Society
  • The US Preventive Services Task Force (do not recommend routine PSA testing).
  • Reviewed last on: 9/23/2010
  • Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

American Urological Association. Prostate-specific antigen best practice statement: 2009 update. April 2009. Accessed July 10, 2009.

Lin K, Lipsitz R, Miller T, Janakiraman S; U.S. Preventive Services Task Force. Benefits and harms of prostate-specific antigen screening for prostate cancer: an evidence update for the U.S. Preventive Services Task Force. Ann Intern Med. 2008;149:192-199.

Lim LS, Sherin K; ACPM Prevention Practice Committee. Screening for prostate cancer in U.S. men ACPM position statement on preventive practice. Am J Prev Med. 2008;34:164-170.

Walsh PC, DeWeese TL, Eisenberger MA. Clinical practice. Localized prostate cancer. N Engl J Med. 2007;357:2696-2705.

Walter LC, Bertenthal D, Lindquist K, Konety BR. PSA screening among elderly men with limited life expectancies. JAMA. 2006;296:2336-2342.

Wolf AM, Wender RC, Etzioni RB, Thompson IM, D'Amico AV, Volk RJ, et al. American Cancer Society guideline for the early detection of prostate cancer: update 2010. CA Cancer J Clin. 2010;60:70-98.

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