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The Difference Between PSA Screening And PSA Testing

Prostate cancer is the third most common form of cancer among men in Singapore, causing about 100 deaths and creating 500 new cases yearly.

The prostate specific antigen (PSA) is a protein produced by cells in the prostate gland. During a PSA test, the level of PSA in the blood is measured. The doctor takes a blood sample, and the PSA level is measured in a laboratory.

Because PSA is produced by the body and can be used to detect diseases, it is sometimes called a biological marker or a tumour marker.

Generally, healthy men do not need to undergo a PSA test in order to screen for prostate cancer. According to the Singapore Urological Association (SUA), there is a need for the public to understand that there is a difference between PSA screening and PSA testing.

PSA screening is a process whereby all men of a specific age group are required to undergo, regardless of how susceptible they are to the disease. A PSA test is usually advised for men between the ages of 50 and 75, and especially for individuals who have a family history of prostate cancer, or who are experiencing urinary abnormalities, which can potentially be a sign of prostate cancer.

Many local clinics include PSA testing as an option in health-screening packages. Even if they are not identified as part of a high-risk group, men can opt to undergo a PSA test. SUA President Dr. Michael Wong Yuet Chen said, "In Singapore, we do not advocate population screening of prostate cancer in asymptomatic men using the PSA test, mainly because PSA screening is not a cost-effective tool for all asymptomatic men. This is especially so in men with short life expectancy, such as those above 75 years old, or those with serious medical conditions where there are competing causes of death. We advocate careful risk assessment and patient counselling about prostate cancer detection by a well-trained physician. In those with abnormal PSA tests where further evaluation is necessary, discussion with a urologist experienced in the care of prostate cancer is recommended. In experienced hands, the risks of over-diagnosis, over-treatment and adverse events after treatment of prostate cancer can be minimised."

For more information, please click the following:

Prostate Cancer Screening: Careful Risk Assessment Vital. A letter written by Dr Michael Wong Yuet Chen, the President of the Singapore Urological Association

Why Prostate Test is Being Peddled. A Reply written by Professor Tommy Koh

Screening for Prostate Cancer – The Controversy That Refuses to Die. An article published by Dr. Michael J. Barry

Early Cancer Screening Not Always Better. Article published in The Strait Times

 

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