Cancer screening is a surprisingly controversial topic these days as public health officials, epidemiologists and academic researchers attempt to sort out questions about whether screening tests actually save many lives and, if so, at what cost. Right near the top of the list of tests being so questioned is the PSA blood test as a screening tool for prostate cancer.

Whether men with no special risk factors should undergo this test is a complicated issue that we won’t try to settle here, but there remain a significant number of men who either want or need to have regular PSA tests. For them, the MD Anderson Cancer Center at the University of Texas has developed a tracking system that helps patients assist their doctors in spotting warning signs of prostate cancer. It’s helpful, easy to use and free — exactly the kind of information I like to feature in Daily Health News.

Make Test Results Meaningful

I spoke with John Davis, MD, assistant professor in the department of urology at The University of Texas MD Anderson Cancer Center in Houston and one of the architects of this new tool. Dr. Davis told me that the tracking system can help make PSA tests more valuable and meaningful for those who choose to have them.

When this simple tool is maintained and discussed by doctor and patient, it enhances the value of the PSA test in several ways:

  • It provides a clear, easily stored record that can be quickly consulted.
  • It can serve as a reminder that it is time to have your annual test.
  • It lets the extent and speed (called “velocity”) of any rise in PSA be easily seen over time. This helps the doctor evaluate how meaningful the rise may be and provides an opportunity to recommend other tests to determine whether the patient has cancer. It is important to keep track of velocity, since studies have linked it — not just the actual level of PSA — to the risk of death from prostate cancer. If the velocity is high, Dr. Davis said, the patient can be treated earlier and more aggressively.

The tool is a simple, two-page form on which patients and/or doctors can record basic information, including the patient’s name and age, the doctor’s name, dates of tests and the results in nanograms of PSA per milliliter of blood. You can print a copy at

PSA Test — Who Needs It?

While this is a question you should discuss with your own doctor, Dr. Davis is of the opinion that men should begin annual PSA testing at age 50 unless there are particular risk factors. These include being of African descent or having a close relative (father, brother or son) with prostate cancer. There also is some evidence that a diet high in fat — especially animal fat — increases risk.

If any of those risk factors describes you, Dr. Davis recommends having your first PSA test at age 45.