The standard method of early detection for prostate cancer in the digital rectal examination (DRE) which should be done annually in fit men 50-70 years or if obstructive or other urinary tract symptoms are present.

Serum prostate specific antigen test (PSA) is recommended as a diagnostic adjunct in men with lower urinary tract symptoms or suspicious DRE findings.

Serum PSA is of unknown value however as a population screening test. Although there is good evidence that it increases the detection rate of early stage clinically significant prostate cancers, there is little evidence to date that such early detection leads to reduced mortality; the "gold standard" for evaluating screening tests.

Fit men age 50-70 (men with at least 10 years life expectancy) should be made aware of the availability of PSA as a detection test for prostate cancer. They should be aware of the potential benefits and risks of early detection so they can make an informed decision as to whether to have the test performed.

The BC Cancer Agency statement concerning screening with PSA is:

"Serum PSA is of unknown value as a population screening test. Although there is good evidence that it increases the detection rate of early stage clinically significant prostate cancers, there is little evidence to date that such early detection leads to reduced mortality; the "gold standard" for evaluating screening tests. Fit men (men with at least 10 years life expectancy) between the ages of 50 and 70 should be made aware of the availability of PSA as a detection test for prostate cancer. They should be aware of the potential benefits and risks of early detection so they can make an informed decision as to whether to have the test performed."

See more details of the BC Cancer Agency evaluation of PSA screening.