Know Your Prostate Cancer Risks

Most men are offered prostate screening starting at age 50. However, some would benefit from screening at an earlier age. African-Americans, for instance, are nearly twice as likely to develop prostate cancer. A family history of prostate cancer is also a major risk factor. About 10 percent of cases are associated with family history, where the heredity pattern for prostate cancer is between father and son or two brothers. Research implicates specific gene mutations in these families that lead to prostate cancer susceptibility.
Earlier screening
If your brother or father had prostate cancer, your own risk doubles and continues to rise with the number of relatives having the disease. If they developed prostate cancer at a young age, the risk is still higher. For men without any relatives with prostate cancer, screening tests (DRE and PSA) should begin at age 50. For those with a first-degree relative (father or brother) with prostate cancer, doctors offer screening at 45.
The importance of family history
If your father or brother has prostate cancer, you are more likely to develop the disease six or seven years earlier than men without any history of prostate cancer in the family.
The more relatives, the higher the risk. Three or more relatives increase the risk by 35 to 45 percent.
If your father was diagnosed younger than age 60, your risk is about 20 percent greater than the general population.
The prostate gland and screening
The prostate gland sits below the bladder, in front of the rectum and surrounds the urethra (urine tube) that leads into the penis. The prostate turns the semen into a favorable environment for sperm. The screening tests take advantage of the prostate's relatively easy access and one of its products, prostate specific antigen (PSA).
Digital rectal exam (DRE)
The back portion of the prostate is close to the rectum. So a doctor can feel the surface of the prostate by inserting a gloved finger and feeling for lumps or any irregularities on the surface.
Prostate specific antigen (PSA) test
The PSA is a blood test for a protein unique to the prostate gland. Most PSA exists in semen, but a small portion of it is circulating in the blood. If greater than a count of 4, the risk for prostate cancer increases. The "normal" for each man depends on several factors, including age and size of the prostate. An elevated PSA level may also indicate that there is an infection of the prostate (prostatitis). Doctors don't make any decisions based on a single PSA reading, but observe changes in PSA over time. The results help the doctor decide whether a biopsy is necessary to see if there is cancer within the gland.
What you can do
Know your prostate family history: Who has or had prostate cancer? At what age were they diagnosed?
Don't panic if you find out there is a family history of prostate cancer. Remember: prostate cancer grows very slowly compared to other kinds of cancer. Thus, if diagnosed early enough prostate cancer can be cured.
Get screened. The American Cancer Society recommends that men with a family history of prostate cancer be screened at age 45 (usually screening starts at 50).