Thomas Baiocco is 63 years old and keeps up with his annual physicals. Including the PSA test which doctors use to screen for prostate cancer.
“For me it’s a good indicator along with the other tests that I have part of my yearly screening.”
But the PSA leaves much to be desired when it comes to reliability.
“Overall PSA is a very poor test. Chances that somebody has an elevated PSA and he has prostate cancer is about 30%. If your PSA is between 4 and 10, and so it’s not a very accurate test,” says Meir Daller, a urologist on the medical staff of Lee Memorial Health System.
Because of that, many doctors are treating a high prostate score purely as a red flag. Based on the results some are now following it up with another screening test, the PCA3.
“The PCA3 is a urine test. We essentially we take the urine specimen from a patient after prostate examination and we extract some genetic material from it,” says Dr. Daller.
The PCA3 looks for two genetic “fingerprints”, called biomarkers, which are prevalent in most prostate cancers.
“We do a lot of prostate ultrasound biopsy because the PSA’s elevated. So we try to decrease those in number. The more accurate the test is, the less the chance that we’re going to do a biopsy on somebody unnecessarily,” says Dr. Daller.
The PCA3 is covered under many insurance plans, in conjunction with an elevated PSA.
“Most insurances matter of fact, do cover it. Medicare does cover PCA3 so if your doctor has a good indication. Medicare will cover PCA3,” says Dr. Daller.
Thomas is comfortable with his routine testing, which has never yielded a red flag.
“Luckily I haven’t had any of those and we sort of follow the PSA results, year to year.”
But as doctors search for the most reliable testing, the answer may be in our DNA.