Prostatic Specific Antigen (PSA) – Critical role in Prostate Cancer screening.

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What is PSA?

Prostatic Specific Antigen, or PSA, is a widely used tumor marker in the screening, diagnosis and monitoring treatment response of prostate cancer.

Prostate cancer is on the increase worldwide and more so among men in Kenya. It’s the 2nd most common cancer in men after lung cancer.

Prostate cance is the leading cause of male cancer related deaths in Kenya

Globocan, 2020
Prostatic Specific Antigen

Risk factors for Prostate Cancer

Risk factors increase someone’s chances of getting a disease but are not a direct cause in themselves. Studies have suggested the following as risk factors for prostate cancer:-

  • Age – Most patients are over 50 years
  • Race – More common in African men than Caucasians
  • Family history – Prostate cancer that runs in families accounts for ~20% of cases
  • Hereditary Breast /Ovarian Cancer Syndrome

Signs and symptoms

During the early stages, prostate cancer is clinically silent. One of the biggest challenges in the management of prostate cancer is the fact that by the time symptoms appear, the disease is already progressed. Some of the symptoms are:-

  • Urinary symptoms
  • Perineal pain
  • Bone pain

Screening

Screening is defined as detecting the presence of disease before its clinically apparent. For prostate cancer, blood levels of the Prostatic Specific Antigen (PSA) have been used as a marker of cancer. It’s however very important to note the test is neither very sensitive nor specific enough and the interpretation must be correlated with other investigations and clinical picture.

What is PSA

This is a protein( enzyme) normally produced by epithelial cells of the prostate. Its normal function is to liquefy the semen and allow sperm to effectively swim towards the ova.

Reference levels

The levels of 0-4ng/ml are taken as normal for adult males. However, the levels are known to change with age, and this should be taken into account when interpreting.

Some of the benign conditions that may cause an increase include-

  1. Benign prostatic enlargement
  2. Prostatitis
  3. Digital rectal examination
  4. Post ejaculation

Reference levels for PSA

Age Bracket (years)PSA Reference Range (ng/ml)
40-490-2.5
50-590-3.5
60-690-4.5
+700-6.5
Reference values for PSA by age

Utility of PSA in screening for prostate cancer

In most countries, there are no clear guidelines for the use of PSA for prostate cancer screening. The use and interpretation of PSA levels should be individualized. Extreme care should be taken especially when these tests are advertised as part of “Well-Man Checkups”. False-positive and negative results can lead to patient harm.

Apart from spot levels, velocity or the rate of increase of PSA levels over time are more important. Such an increase may mean cancer has recurred after surgery or radiotherapy treatment.

What is the cost of PSA Cost In Kenya?

The cost of PSA tests in Kenya varies widely based on factors like the type of facility and location. At Labtestzote, we ensure the most competitive and affordable PSA test. Click here to see our pricing for the PSA test

Conclusion:

PSA is an important test in the screening of prostate cancer. It should be used with caution, taking into account all other clinical, and radiological factors when interpreting it.

In case you have any queries about this test, be sure to contact us for a free consultation.

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