Prostate cancer screening in younger men: prostate-specific antigen and public awareness

The American Cancer Society recommends annual digital rectal examination for men over forty years of age. We evaluated 414 men between forty and fifty-nine years of age with a questionnaire, digital rectal examination (DRE), and prostate-specific antigen (PSA) determination. One hundred ninety were forty to forty-nine years old, and 224 were fifty to fifty-nine years old. Four patients in the forty to forty-nine age group had elevated PSA determinations, and 7 had abnormal findings on DRE. Using prostate ultrasound and biopsy, no cases of prostate cancer were diagnosed. Ten patients in the fifty to fifty-nine age group had elevated PSA determinations, and 5 were diagnosed to have prostate cancer. These data suggest that PSA may have utility in detecting cancer in younger men.