PSA Screening Tests

Emma Howard: Hello! I'm Emma Howard. I'm joined by Dr. Jonty Heaversedge who is an expert on men's health problems. Hello Jonty! Dr. Jonty Heaversedge: Hi Emma! Emma Howard: I've got a simple question here, although I know complicated answer I'm sure but put simply, why aren't all men given PSA screening test. Now PSA is to do with prostate. Isn't it? Dr. Jonty Heaversedge: That's right. Yeah. PSA stands for Prostate Specific Antigen and it's actually produced by normal cells in the prostate as well as by cancer cells in the prostate. I guess that's why, that actually gives you half the answer there. That's why we don't use it for screening in this country at the moment because it can be raised. If you imagine, you do a blood test and it comes back high, it can be raised for conditions that are not cancerous, so it can be raised in conditions such as infection or even in a benign condition where the prostate enlarges. So that means as a test it's not accurate enough to use in screening. Emma Howard: So it's not like breast cancer screening because clearly I think this question is come from a man who is saying if you screen for breast cancer for all women in this country, why can't you do it for men in the prostate? Dr. Jonty Heaversedge: Absolutely. And the answer is simply that we don't yet know enough about PSA to use it for that. In America over 50, they're all using it. But this is to try and make it a little bit clearer, there are couple of risks with this. One is that some men have prostate cancer and have a normal PSA. So if you rely on a test, you may re-assure people incorrectly that they don't have cancer. The second thing is that a lot of men, probably up to two-thirds of men may have a raised PSA but no cancer present. So what do we do with those men, if they go on to have other investigations which in themselves have risks attached to them. Then actually we're putting people through unnecessary further testing. So it's just not clear enough test yet first to use it. But there are some big trial going on in Europe that may give us a little bit more information about on the levels of PSA and how we can be a bit more specific and use it as a more helpful tool then I think we can at the moment. Emma Howard: So, cleanly it is a screening test that happens in this country only when you are sort of down the road of investigating a prostate problem. Dr. Jonty Heaversedge: Precisely. Yes, that's exactly right. If you get symptoms suggestive of prostate problem and if you're having difficulty on passing urine, if you're having to get up more frequently at night, any symptoms like that, go along and see the doctor, and the doctor will then do two things. He will examine the prostate which involves a rectal examination which a lot of men I know avoid, but actually it's a very good test for prostate cancer. He or she will also arrange for you to go and have a PSA test at that point and in conjunction with symptoms and an examination. Emma Howard: It gives you a bit of reading. Dr. Jonty Heaversedge: Yeah. Emma Howard: That was very clear. Thank you very much for that Jonty. Well, if you have a similar problem, we hope we might have given you some help. But remember, it's always best to go and see your own doctor for medical advice. Thanks for watching. We'll be back with more health questions and answers.