Prostate cancer screening can sound simple until you start hearing terms like PSA test, prostate exam and digital rectal exam (DRE). Are they the same thing? Does one replace the other? And if your PSA is normal, do you still need to talk with your doctor about prostate health?
The short answer is that these screening tools provide different information. A PSA test measures a substance in the blood, while a prostate exam allows a healthcare provider to physically evaluate the prostate for certain changes or abnormalities.
During Prostate Cancer Awareness Month, Kansas City Urology Care (KCUC) is helping men understand what these tests can – and cannot – tell you, so you can have a more informed conversation about prostate cancer screening.
What Is a PSA Test?
PSA stands for prostate-specific antigen, a protein produced by cells in the prostate. A PSA test is a blood test that measures the amount of PSA in your bloodstream. PSA testing can help identify changes that may warrant additional evaluation. However, an elevated PSA does not automatically mean prostate cancer. PSA levels can also be affected by non-cancerous prostate conditions, including benign prostatic hyperplasia (BPH) and inflammation or infection.
That is why physicians do not interpret a PSA number in isolation. Your age, health history, family history, previous PSA results and other individual factors can all provide important context.
What Is a Prostate Exam?
A prostate exam may include a digital rectal exam, commonly called a DRE. During this brief physical examination, a healthcare provider evaluates the prostate for certain changes, such as differences in size, shape, firmness or areas that feel unusual.
Unlike a PSA blood test, a prostate exam does not measure PSA levels. Instead, it gives the provider physical information about the prostate that a blood test cannot provide.
KCUC includes PSA testing and prostate examination as part of its approach to prostate cancer screening, with recommendations tailored to each patient’s risk factors and overall health. Schedule your appointment with KCUC today.
PSA Test vs. Prostate Exam: What’s the Difference?
The easiest way to think about the difference is that the tests look at prostate health from two different angles:
- PSA test: A blood test that measures prostate-specific antigen in the bloodstream.
- Prostate exam (DRE): A brief physical examination that allows a provider to evaluate certain characteristics of the prostate.
Together with your health history and risk factors: The results can help your healthcare provider determine whether routine follow-up or additional evaluation may be appropriate. Neither test by itself provides a complete picture of prostate health, and neither test alone diagnoses prostate cancer. Schedule an appointment with KCUC today.
Can a PSA Test Diagnose Prostate Cancer?
A prostate exam also cannot diagnose prostate cancer by itself. If a provider identifies something unusual during an examination, that finding may lead to additional testing. A diagnosis of prostate cancer requires evaluation beyond a screening exam. When appropriate, advanced imaging and prostate biopsy can provide the information needed to determine whether cancer is present.
Who Should Talk With a Doctor About Prostate Cancer Screening?
There is not one screening schedule that is right for every man. The appropriate time to begin screening conversations can depend on your age, overall health and personal risk factors.
Factors that may affect prostate cancer risk include age, family history, African American ancestry and certain inherited genetic changes. Men with higher-risk factors may need to begin conversations about screening earlier than men at average risk.
Rather than waiting for symptoms, talk with KCUC about your individual risk and when prostate cancer screening may be appropriate for you.
Why Screening Matters Even If You Feel Healthy
One of the challenges with prostate cancer is that early disease may not cause noticeable symptoms. Feeling well does not necessarily tell you what is happening with your prostate.
Screening is intended to help identify potential concerns before they would otherwise become obvious. Your healthcare provider can help you weigh the potential benefits and limitations of screening based on your age, health and risk profile.
If you do develop urinary changes, blood in the urine or semen, pelvic discomfort or other new urologic symptoms, those symptoms also deserve medical evaluation rather than waiting for a routine screening visit.
Frequently Asked Questions About PSA Tests and Prostate Exams
Is a PSA Test the Same as a Prostate Exam?
No. A PSA test is a blood test that measures prostate-specific antigen. A prostate exam, such as a DRE, is a physical examination that allows a healthcare provider to evaluate certain characteristics of the prostate.
If My PSA Is Normal, Does That Mean I Don’t Have Prostate Cancer?
A PSA result is one part of prostate cancer screening and risk assessment. Your provider may also consider your health history, family history, previous PSA results, physical findings and other individual factors when discussing prostate health.
Does a High PSA Always Mean Prostate Cancer?
No. PSA can be elevated for reasons other than prostate cancer, including benign prostate enlargement, inflammation and infection. An elevated result may lead your provider to recommend additional evaluation.
What Happens If My PSA or Prostate Exam Is Abnormal?
Your urologist may recommend additional evaluation based on the finding and your individual risk. Possible next steps can include repeat testing, prostate MRI or biopsy when appropriate.
Do I Need Prostate Cancer Screening If I Have No Symptoms?
Prostate cancer may not cause noticeable symptoms in its early stages. Whether screening is appropriate, and when it should begin, should be discussed with your healthcare provider based on your age, health and individual risk factors.
Talk With KCUC About Your Prostate Health
Understanding the difference between a PSA test and a prostate exam can make prostate cancer screening feel less confusing. These tools provide different information, and your healthcare provider can help determine how they fit into your individual prostate-health plan. Whether you are due for a screening conversation, have questions about your PSA history or have a family history of prostate cancer, KCUC’s urology and oncology team can help you understand your risk and determine appropriate next steps. Schedule your appointment with KCUC today.
Sources & Additional Resources
National Cancer Institute – Prostate-Specific Antigen (PSA) Test
National Cancer Institute – Prostate Cancer
This information is intended for educational purposes and should not replace individualized medical advice. Talk with your healthcare provider about prostate cancer screening, PSA testing, prostate examinations or other questions about your prostate health.