Why Men Should Have a PSA Test At 40

In 2012, the United States Preventive Service Task Force (USPSTF) advocated against urologists from using the Prostate Specific Antigen (PSA) test to screen men for prostate cancer.  Their argument was that the benefits of PSA testing in men may not justify the cost of implementing PSA as a screening tool and there were concerns of the harms of PSA outweighing the benefits.

“This is wrong and foolish advice by a governmental agency,” exclaimed Dr. David Samadi.  “Why would we want to gamble a man’s life by forsaking an excellent diagnostic tool, the PSA exam that can catch prostate cancer in men in their 40’s when it is often more aggressive?”

An article published by Dr. Samadi did a comparison of 2,495 men with prostate cancer who underwent SMART prostate cancer surgery.  The results showed that younger men when compared to older men with similar demographic, clinical, and pathologic function had surgical recovery that was statistically superior to the older men.  These findings demonstrate that young men below the age of 50 should be screened for prostate cancer as their treatment and surgical outcomes are more favorable at a younger age.

The PSA test is a simple blood test that measures the amount of prostate specific antigen present in the blood as is used to screen for prostate cancer.  PSA is a protein that men have in their blood which is released by the prostate gland.  In healthy men, the amount of PSA is low – generally less than 4.0 ng/ml.  However, as men age, their prostate can experience physiological or pathological changes which cause the PSA to rise.

Other findings from the study revealed that waiting until screening a man’s PSA until the age of 50 or older, can result in missing an early diagnosis in up to 11% of patients who have the disease.  Approximately 271 men from the study were found to have significant prostate cancer at the mean age of 46. 

When there is a delay in diagnosing prostate cancer, this only leads to an advanced stage of the disease when it finally is discovered where it may have already metastasized complicating treatment and the outcome.

“With the current technology we have in robotic surgery, this can be a literal lifesaver for many men who have a prostate cancer diagnosis,” said Dr. Samadi.  “The SMART surgery I developed and use shows that at 12-months post-surgery, 89% of men are cancer free, 94% of young men and 83% of older men have normal sexual function while 96% of young men and 94% of older men have urinary continence.”  

After the age of 50 a man’s risk for prostate cancer greatly increases. However, men as young as 40 can get prostate cancer and it is often more aggressive. 

September is prostate cancer awareness month and I recommend all men starting at age 40, choose to be screened for prostate cancer by having a PSA test,” Dr. Samadi advised.  “This would help in both detecting early prostate cancer and having a baseline level for comparison with future PSA tests.  The earlier prostate cancer can be diagnosed and treated, the greater likelihood of becoming cancer free.”