Prostate Cancer Screening

Digital Rectal Examination and PSA are two of the best ways to screen for prostate cancer.

The American Cancer Society recommends that the PSA test and the DRE should be offered annually beginning at age 50 to men who have a life expectancy of at least 10 years. Men at high risk should begin testing at age 45. Prior to testing, men should have an opportunity to learn about the benefits and limitations of testing for early prostate cancer detection and treatment.

Men who ask the clinician to make the testing decision on their behalf should be tested. A clinical policy of not offering testing, or discouraging testing in men who request early prostate cancer detection tests, is inappropriate.

High-risk groups include men of African descent (specifically, sub-Saharan African descent) and men with a first-degree relative diagnosed at a younger age. Risk increases with the number of first-degree relatives affected by prostate cancer. The ACS recommends that these men begin testing for early prostate cancer detection at age 45. Men at appreciably higher risk of prostate cancer due to multiple first-degree relatives who were diagnosed with prostate cancer at an early age should be informed regarding possible risks and benefits of screening.

Mi-Prostate Score

For men with an elevated PSA, the University of Michigan has begun offering a new urine test called Mi-Prostate Score to better assess the risk of cancer being present. The test developed from a discovery by U-M researchers of a genetic anomaly that occurs in about half of all prostate cancers, an instance of two genes changing places and fusing together.

This gene fusion, T2:ERG, is believed to cause prostate cancer. Studies in prostate tissues show that the gene fusion almost always indicates cancer.

The new urine test looks for the T2:ERG fusion as well as another marker, PCA3. This is combined with the PSA measure to produce a risk assessment for prostate cancer. The test also predicts risk for having an aggressive tumor, helping doctors and patients make decisions about whether to wait and monitor test levels or pursue immediate biopsy.

The test is available to anyone but requires a request from a doctor. For further information, have your doctor's office can call the University of Michigan's MLabs at 800-862-7284.

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