For years, doctors have been looking for a man’s version of the Pap smear—an early-warning cancer detector that spots a tumor long before it is clinically evident. In this area, no development has been more promising, or controversial, than die PSA test. Recently, you may have heard a lot, good and bad, about this test. The PSA test is not new. In years past, however, its purpose was limited; it functioned mainly as a means of monitoring already-diagnosed prostate cancer and as an indicator of tumor volume. Could its use be expanded? Could it detect cancer that had not yet been diagnosed? The answer, doctors found several years ago, was yes—elevated levels of PSA can indeed point to the presence of cancer. In 1992, the American Cancer Society recommended annual PSA tests for all men over age 50, and over age 40 for men at higher risk (particularly, African-American men and men with prostate cancer in the family.
However, PSA (prostate-specific antigen) is not a magic wand, pointing with resolute certainty toward prostate cancer—and that’s the problem. Even doctors aren’t exactly sure how best to use the test, and how to make sense of the information it provides.
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