Who Should Consider Screening?
Some men are at higher risk of developing prostate cancer, including:
- African American men
- Men with a father, brother, or close relative who had prostate cancer
- Those with a family history of breast, ovarian, or colon cancer
If you fall into one of these categories, we may recommend starting screening at age 40. For men at average risk, we typically suggest starting between ages 45 and 50.
What Is a PSA Test?
The PSA (prostate-specific antigen) test is a simple blood test used to screen for prostate cancer. Elevated PSA levels can indicate cancer, but they can also be caused by:
- Enlarged prostate
- Infection
- Recent ejaculation
- Trauma
That’s why a single elevated result doesn’t mean cancer. At CRH, we confirm elevated PSA levels with a second test and consider your age and other factors when evaluating next steps.
PSA Guidelines by Age:
- Age 40s: Further evaluation if PSA > 2.5
- Age 50s: PSA > 3.5
- Age 60s: PSA > 4.5
- Age 70s: PSA > 6.5
We also recommend avoiding ejaculation for three days before a PSA test, as it can temporarily raise PSA levels.
How Often Should I Be Screened?
- Low-risk men with very low PSA values may screen every two years
- Higher-risk men or those with borderline PSA levels may benefit from yearly testing
- Screening may stop at age 70–75, especially if PSA is under 3 or life expectancy is under 10 years
What If My PSA Is Elevated?
An elevated PSA result doesn’t automatically mean cancer. We may recommend:
- Prostate MRI to look for suspicious areas (scored 1–5 using the PI-RADS system)
- Digital rectal exam to assess prostate size and texture
- PSA density (PSA level relative to prostate size)
- Genetic testing, if family history suggests inherited cancer risk
- Blood or urine biomarker tests to better assess your risk
When Is a Biopsy Recommended?
A prostate biopsy may be recommended if imaging or risk scores indicate a higher likelihood of cancer. We’ll walk through this decision together, considering:
- MRI results (PI-RADS 3, 4, or 5)
- PSA density > 0.15
- Other risk calculators or "nomograms" based on your history
We believe in shared decision-making, which means you and your provider will work together to decide the next best step based on your personal goals and preferences.
Talk to Our Urology Experts
If you're considering prostate cancer screening or have questions about your PSA levels, our team at Columbus Regional Health Urology is here to help.
2326 18th Street, Suite 230
Columbus, Indiana 47201
Phone: 812-376-9261
