Prostate screening examination

Even men who do not have any symptoms are recommended to have their prostates examined regularly by a urologist when they reach the age 50. The purpose of the screening is to detect prostate cancer at an early stage so that it does not spread from the prostate and is easier to treat. What is the screening procedure?

Medical history
The first step of the screening involves is the anamnesis, which is a discussion of the medical history between the patient and the urologist. If, for example, prostate cancer has already occurred in the family, the man himself is at a higher risk for prostate cancer. For this reason, men who have prostate cancer in their family are recommended to have regular screenings already at the age of 45.

Physical examination
During the physical examination (digital rectal examination), the prostate is felt by inserting a finger into the anus. The examination takes only a few minutes. If the family doctor or urologist notices a hard lump, this may be a sign of prostate cancer. Because the digital rectal exam cannot identify all tumours, the screening also includes the testing of the PSA value

PSA value
The PSA value measures a protein that is produced by the prostate gland. It is measured in the blood and can provide indications of a diseased prostate. 

  • An elevated PSA value may be an indication that the prostate is diseased.
  • The reason may be benign prostate enlargement, inflammation, irritation or prostate cancer
  • In European men, a PSA value over 4 ng/ml (nanograms per millilitre) is considered high.
  • In men between the age of 50 and 60, the normal value ranges between 3.5 and 4.5 ng/ml.
  • In men between the age of 60 and 70, the normal value ranges between 4.5 and 5.5 ng/ml.

Further action
If there is a suspicion of prostate cancer, additional tests can be carried out:

  • Ultrasound
  • Examination of lymph nodes
  • Prostate biopsy (tissue sample)
  • Further imaging diagnostics