Should men get a PSA test every year?

The prostate specific antigen (PSA) test measures the level of PSA in the blood. PSA is a protein that can be higher in men with prostate cancer and some non-cancerous conditions. Many men age 50 and older get the test annually. However, recent findings from a major study suggest that men with extremely low PSA levels can have the test less often.

The ongoing Prostate, Lung, Colorectal and Ovarian (PLCO) study is following almost 30,000 men who get PSA tests every year. The researchers found that more than 98 percent of those with very low PSA levels (1 to 2 nanograms) had normal levels the following year. And more than 98 percent of men with extremely low initial PSA levels (under 1 nanogram per milliliter of blood) continued to have extremely low levels over the next four years.

Among men with PSA levels in the 3 to 4 range, 24 percent showed higher levels within a year, and 83 percent showed higher levels within four years.

Men whose last PSA level was less than 1 may want to consider getting the PSA test less often than once a year.

Scientists do not agree on the value of PSA testing. Increased PSA levels do not necessarily mean a fast-growing cancer is present. False positive test results can cause anxiety and unnecessary further testing. Although some prostate cancers will progress significantly, most are very slow-growing.

The PLCO study was designed to find out whether PSA tests save lives. That question has not yet been answered, but researchers will follow the participants until 2007 and more findings are expected.

Meanwhile, men should talk with their doctor about whether and how often to get PSA tests.

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