Prostate cancer screening: when? For whom? Procedure!

Definition - What is Prostate Cancer Screening?

Prostate cancer screening includes an annual examination of the prostate and the external genitalia and is used for the early detection of cancer diseases of the prostate.
This check-up is paid for by the health insurance company from the age of 45.
The preventive medical check-up includes an interview to determine symptoms and risk factors as well as a physical examination.
A "digital rectal examination" is carried out here. The doctor feels the prostate, which is spatially in front of the rectum, through the intestinal wall and pays attention to hardened parts and protrusions of the organ.
In addition to the palpation examination, an ultrasound examination or the "PSA value" in the blood can be checked. This blood test may provide information about an enlargement of the organ or infections in this area.

When should I start prostate cancer screening?

The health insurance companies usually pay for the prostate check-up from the age of 45. Men should take advantage of this offer from this point on, as the risk of developing prostate cancer increases with age.
Of course, there is no question that you should speak to the urologist earlier if there are symptoms before the age of 45 and / or the patient is worried about them.

You may also be interested in this topic: Prostate Cancer Symptoms

What is the prostate cancer screening process like?

Conversation on prostate cancer screening

The procedure of the prostate cancer preventive examination is as follows: In an introductory conversation, the physical state of health should be asked and examined if necessary. The focus here is on possible risk factors, such as where you live, affected family members, chronic illnesses and your own lifestyle. By far the strongest risk factor in prostate cancer is age.

In the further discussion, the most important urological symptoms, such as urinary retention, involuntary urination, impotence or even blood in the urine should be addressed by the doctor and specifically asked about this.
These symptoms are not just signs of prostate cancer, but can occur in many diseases in this area.

Also read our topic: Causes of blood in the urine

Examination for prostate cancer screening

This is followed by an examination of the prostate by means of a "digital rectal" palpation examination and, if necessary, an ultrasound examination of the prostate as well as a PSA value determination in the blood.

The palpation examination is performed through the rectum opening at the front of the intestine and is intended to detect hardening, bulges or enlargements of the prostate.

An ultrasound image of the organ can also be taken at the same point in order to make these changes visible.

The PSA value is a way of detecting enlargement and infection of the prostate, but has recently been viewed critically as a good early cancer marker. Nevertheless, the PSA value is still often part of the preventive check-up.

Read more on this topic at: Examination of the prostate

Illustration prostate cancer

Figure prostate cancer: cancer of the prostate gland (A), male reproductive organs overview from the side (B) and healthy prostate (C)

Prostate cancer (prostate cancer, PCa)
Cancer of the prostate gland
(Malignant tumor disease)

  1. Prostate gland - prostate
  2. Peritoneal cavity -
    Cavitas peritonealis
  3. Ureter - Ureter
  4. Urinary bladder - Vesica urinaria
  5. Male urethra -
    Urethra masculina
  6. Male member - penis
  7. Testicles - Testis
  8. Rectum - Rectum
  9. Cystic gland (seminal vesicle) -
    Glandula vesiculosa
  10. Nodular tumor tissue
  11. Malignant tumor
  12. Urine (urine) - Urina
  13. Glandular tissue of the prostate

You can find an overview of all Dr-Gumpert images at: medical illustrations

How do I prepare for prostate cancer screening?

This cancer screening exam does not require any special preparation.
In some cases, however, it may be advisable not to ride a bike or have frequent sexual intercourse in the days leading up to an examination to prevent irritation of the prostate. This could possibly falsify the test values. If you have any questions, ask your doctor before the screening appointment.

When should prostate cancer screening be repeated?

The check-up should be carried out annually from the age of 45.

If there is a reasonable suspicion of an illness or if an illness has been detected, more frequent examinations may be necessary.

In addition, it is always advisable to repeat the preventive medical examination if there are acute symptoms.

Also read: Prostate Cancer Cure Chances

Which doctor does prostate cancer screening?

Prostate cancer screening is usually carried out by a urologist.
However, some general practitioners also offer this examination as part of further preventive measures. Regardless of whether it is a urologist or a general practitioner, it is only important that he or she has the necessary experience to discover cancer if necessary.

Read more on this topic at: The urologist

Is the PSA value also determined during prostate cancer screening?

The PSA value should not necessarily be determined at every preventive medical examination. This examination is often not covered by the health insurances and has to be paid for yourself.
If there is no suspicion of cancer and if the value was previously low, this value does not have to be checked annually.

When it makes sense to re-determine it depends heavily on the last result of the PSA value. The higher the value, the more often it should be checked. If the PSA value is less than 1ng / ml, a new determination in four years is sufficient.

Read more on this topic at: PSA level in prostate cancer

You can find general information on the PSA value here: PSA value

Who bears the costs of the examination?

From the age of 45, the costs of the prostate cancer screening examination are covered once a year by the health insurance companies. However, the determination of the PSA value often has to be done in-house.
If you want to find out more about this, you should obtain more information directly from the respective health insurance company.

Why is prostate cancer screening sometimes considered controversial?

Unfortunately, it can be assumed that many patients are over-treated as a result of prostate cancer preventive examinations, which means that some of the cancers discovered would never have caused symptoms during the patient's lifetime.
It is therefore recommended to inform the patient about the possibility of early detection, but to inform him about the advantages and disadvantages of the preventive medical check-ups.

Men who would like preventive measures after being informed can be offered to have their PSA value determined. In addition, a digital rectal examination should be performed as standard.

In addition, prostate cancers are relatively often not immediately discovered despite preventive examinations and require further examinations in order to be able to determine the disease beyond doubt.

Nevertheless, preventive examinations are important and are always advisable in case of doubt.

You may also be interested in this topic: Treatment of prostate cancer