Prostate Cancer Screening
What Is It?
Prostate cancer is the most common cancer in men (excluding skin cancer). PSA screening is controversial - shared decision-making is essential. Most prostate cancers are slow-growing.
How Is It Diagnosed?
PSA test. Digital rectal exam (DRE). Discuss with men 55-69 years (USPSTF). High-risk (African American men, first-degree relative with prostate cancer): consider earlier screening. Elevated PSA leads to multiparametric MRI prostate then biopsy.
How Is It Treated?
Active surveillance for low-risk. Radical prostatectomy or radiation for intermediate-high risk. Hormone therapy (ADT) for advanced/metastatic. Urology referral for elevated PSA or biopsy.
Tests and Imaging Typically Needed
PSA with free PSA ratio, DRE, mpMRI prostate, TRUS-guided or MRI-guided biopsy, Gleason scoring.
Approximate Self-Pay Costs
Office visit: $95-$150. PSA: $20-$40. Prostate MRI: $700-$1,500. Urology referral for elevated PSA.