Prostate Cancer Screening Tests and Prevention

Medically Reviewed by Nazia Q Bandukwala, DO on May 09, 2022
6 min read

There’s no proven way to prevent prostate cancer, but you may be able to lower your risk for it.

A diet that helps you stay at a healthy weight may lower your chances for the disease. The American Cancer Society recommends that you:

  • Limit high-fat foods.
  • Cut back on red meats, especially processed meats like hot dogs, bologna, and certain lunch meats.
  • Eat five or more servings of fruits and vegetables each day.

Some other healthy food choices are whole grain breads and cereals, rice, pasta, and beans.

Antioxidants in foods, especially in fruits and vegetables, help prevent damage to the DNA in the body's cells. Such damage has been linked to cancer.

Lycopene, in particular, is an antioxidant that has been linked to a lower risk for prostate cancer. You can get it from foods like:

  • Tomatoes -- both raw and cooked
  • Spinach
  • Artichoke hearts
  • Beans
  • Berries -- especially blueberries
  • Pink grapefruit and oranges
  • Watermelon

Still, it's not clear whether lycopene actually helps prevent prostate cancer, and recent studies have not been able to show that it does.

Researchers keep studying other ways to lower prostate cancer risk. It's still too soon, though, to know whether studies are finding new ways to help prevent prostate cancer.

Here are some examples of what's being considered:

  • Some doctors are looking at whether certain drugs can help prevent prostate cancer, like Avodart (dutasteride) and Proscar (finasteride). Those are both used to treat an enlarged prostate that isn't cancerous.
  • Early studies show that the mineral selenium may lower your chance of getting prostate cancer or slow the disease from getting worse.  
  • Doctors continue to study the effects of supplements on prostate cancer. For now, no vitamins or supplements are known to lower the risk.

Screening tests look for possible signs of a disease inside your body before you have any symptoms of it. It’s common for doctors to use these two tests to screen for prostate cancer:

Prostate-specific antigen (PSA) blood test. PSA is a protein that cells in your prostate gland make. It mostly shows up in semen, but there’s a small amount in your blood.

Your chance of having prostate cancer rises as your PSA level goes up, but there’s no clear cutoff point that can tell your doctor for sure if you do or don’t have the disease.

Ask your doctor to explain your numbers. If your PSA level is high, they may recommend that you get more tests to check for prostate cancer.

Digital rectal exam. Your doctor places a gloved, lubricated finger into your rectum and feels for any possible signs of cancer, like bumps or hard areas on your prostate. It may feel uncomfortable, but it shouldn’t be painful or take long.

The digital rectal exam doesn’t spot signs of prostate cancer as well as the PSA blood test does, but it could help your doctor find the disease if your PSA level is normal. That’s why it might be part of your prostate cancer screening.

Scientists are also working on making newer tests that are based on other types of PSA, or on other signs of tumors. The American Cancer Society says that some of the tests might be more accurate than the PSA blood tests. They include:

Prostate health index (PHI): This combines the results of three types of PSA tests (total PSA, free PSA, and proPSA) to help your doctor figure out how likely it is that you have prostate cancer that might need to be treated.

4Kscore test: This combines the results of three types of PSA tests (total PSA, free PSA, intact PSA). It checks for a sign linked to prostate tumors kallikrein 2 (hK2) and some other factors to help your doctor find out how likely it is that you have prostate cancer that might need to be treated.

Prostate cancer antigen 3 tests (like Progensa): These tests check the level of genetic material called PCA3 in your pee after you get a digital rectal exam, which pushes some of the prostate cells into your urine. The higher your PCA3 level, the more likely you have prostate cancer.

Tests for TMPRSS2:ERG. That’s an abnormal gene change found in some prostate cancers. Doctors can use tests that check your pee for it after giving you a digital rectal exam.

ExoDx Prostate (IntelliScore): This test checks the levels of three signs in your pee to help your doctor figure out your risk of having aggressive, or high-grade, prostate cancer. High-grade cancer cells usually grow and spread faster than low-grade ones.

ConfirmMDx: This test checks certain genes in the prostate cells gathered during a biopsy.

The American Cancer Society says that newer tests like these probably won’t replace the PSA blood test in the near future, but they could be helpful to your doctor in certain situations.

For instance, if you have a slightly higher than normal PSA level, some of these tests might help the doctor figure out whether a prostate biopsy would be right for you. And if you already had a biopsy that didn’t find prostate cancer, some of the tests might help the doctor decide if you should get another biopsy.

Testing or screening for prostate cancer can help your doctor spot it earlier. But experts disagree on when and if this testing should be done.

The American Cancer Society recommends that men talk to their doctor before having a screening test to check for prostate cancer. That way you’ll understand the risks and benefits of testing. Then, you and your doctor can decide whether to go ahead with screenings using a PSA test and digital rectal exam.

When that discussion should take place is based on your age, level of risk, and general health.

Different expert groups have different prostate cancer screening guidelines. Talk to your doctor about what’s right for you.

The American Cancer Society’s general recommendations about when to consider testing are:

  • If you have no symptoms and your doctor has told you that you’re at average risk for prostate cancer, discuss screening starting at age 50.
  • If you’re at higher risk, have the discussion starting at 45. This is extra important if you’re African-American or if you had a brother, father, or son who got diagnosed with prostate cancer before the age of 65.
  • Talk to your doctor when you’re 40 if you have two or more first-degree relatives -- brother, father, or son -- who were diagnosed with prostate cancer before the age of 65.

The American Urological Association suggests that if you’re thinking about getting screened, talk to your doctor about it if you’re 55 to 69 years old. Ask them about the risks and benefits of testing, and use your personal values and preferences to help decide if it’s right for you.

The group doesn’t recommend:

  • PSA screening if you’re under 40 years old.
  • Routine screening if you’re 40 to 54 with an average risk for prostate cancer.
  • Routine PSA screening if you’re over 70 or if you have less than a remaining 10- to 15-year life expectancy.

The U.S. Preventive Services Task Force says that PSA testing may be appropriate for some men between the ages of 55 to 69. If that’s you, the group recommends that you discuss the pros and cons of testing with your doctor.

Again, the recommendations vary. Ask your doctor what’s right for you if you decide to get screened.

The American Cancer Society says that if a screening test shows you don’t have prostate cancer:

  • You may need to get retested every 2 years if your PSA blood test shows that your PSA level is less than 2.5.
  • You should get screened once a year if your PSA level is 2.5 or higher.

The American Urological Association recommends that you ask your doctor whether you should get screened every 2 years instead of once a year.

A couple of the risks to discuss with your doctor are:

Overdiagnosis. This means you get diagnosed with a condition that wouldn’t have caused symptoms or problems. Some prostate cancers grow so slowly that they’d never give you problems during your lifetime. So, you could end up getting tests or treatments that you don’t need.

False-positive test result. This is an incorrect result. It says you have a certain health condition when you actually don’t. It could lead to follow-up tests that you don’t need.

If you’re thinking about getting screened for prostate cancer, here are some questions to ask at your next doctor appointment:

1. Am I at higher-than-normal risk for prostate cancer?

2. Would I benefit from getting a screening test for it?

3. What risks do I face if I decide to be tested?

4. If cancer is found, should I be treated? What will determine that?

5. When is "watchful waiting" a better option than treatment? And what does that involve?