Should I Get Screened for Prostate Cancer? What to Know About Prostate Cancer Screening Guidelines

Prostate cancer is one of the most common cancers in the world. And just like many other cancers, it’s possible to “screen” for prostate cancer. Cancer screening tests find cancers before they cause problems (symptoms) in your body. Cancer screening is a way to find cancers early, while they’re still relatively easy to treat.

But here’s the tricky part. Many prostate cancers grow slowly. For some people, prostate cancer can grow so slowly that it won’t ever cause them problems. For this group of people, screening may not be worth it. But other people develop more aggressive forms of prostate cancer. For this group, screening can be lifesaving. 

So, how can you know if screening is right for you? It depends on many factors. Here’s what to know about prostate cancer screening.

What tests are used to screen for prostate cancer?

There are several tests that screen for prostate cancer. These tests aren’t perfect, so they’re often used together. This may help increase the chances of accurately identifying people who have prostate cancer. 

PSA (prostate-specific antigen) testing

A prostate-specific antigen (PSA) test is a blood test that shows how much PSA is in your blood. PSA is a protein your prostate makes. 

PSA can be higher in people with prostate cancer. But other medical conditions can also raise your PSA level, like:

• An enlarged prostate (benign prostatic hyperplasia)

• Pelvic surgeries

• Certain medications

• Prostate infections (prostatitis)

Interpreting a PSA level isn’t always straightforward. A high level doesn’t mean someone definitely has prostate cancer. But a high PSA level is often a sign that people should get other tests, like a prostate biopsy, to confirm whether or not they have prostate cancer.

Digital rectal exam (DRE)

A digital rectal exam (DRE) is part of the physical exam. During a DRE, a healthcare professional inserts a gloved finger into your rectum, to feel for lumps and bumps on your prostate. 

The U.S. Preventive Services Task Force (USPSTF) doesn’t recommend a DRE as a screening test for prostate cancer. But your healthcare team may recommend a DRE after PSA testing, especially if your PSA levels are “borderline” (meaning they’re only a little bit higher than normal). 

EXPERT PICKS: WHAT TO READ NEXT

• Learn the signs of prostate cancer. Take a look at the five most common symptoms of prostate cancer. 

• Does what you eat affect your risk for prostate cancer? Yes, here are nine foods that can lower your risk for prostate cancer.

• Genetics and prostate cancer: Learn how your genes can affect your risk of developing prostate cancer.

A healthcare professional might also suggest a DRE to look for an enlarged prostate, especially if you’re having prostate-related symptoms. 

What are the pros and cons of prostate cancer screening?

It’s essential to understand the pros and cons of prostate cancer screening, so you can make the choice that’s right for you.

Pros

The benefit of prostate cancer screening is that it can catch prostate cancer early, so you can get treated as soon as possible. And getting early treatment may improve your chances of long-term cancer control — especially if you have high-risk prostate cancer. 

Cons 

PSA levels and a DRE aren’t perfect exams. A high PSA level usually requires more invasive medical tests — like a prostate biopsy — to confirm whether or not someone has prostate cancer. And while prostate cancer screening can catch high-risk cancers, it can also find cancers that won’t cause any health problems because they grow so slowly. This means, in some cases, prostate cancer screening can lead to unnecessary medical procedures and treatments.

At what age should you start prostate cancer screening?

If you have symptoms of prostate cancer, talk to your primary care provider as soon as possible — no matter how old you are. Symptoms of prostate cancer can include:

• Needing to strain to start urinating

• A weak urine flow 

• A urine stream that starts and stops

• Blood in your urine or semen

• Persistent or worsening bone or joint pain in one spot

• Extreme fatigue

• Unintended weight loss

If you don’t have any symptoms, here’s what the USPSTF currently recommends, based on your age.

Remember, these screening recommendations only apply if both of the following are true: 

• You don’t have prostate cancer symptoms.

• You’ve never been diagnosed with prostate cancer. 

If you’re younger than 55

You likely don’t need prostate cancer screening, but there are a couple of exceptions. Talk with your healthcare team if you have a first-degree relative who was diagnosed with prostate cancer at a young age, like your father or brother. You should also talk with your team if you have a history of a BRCA1 or BRCA2 mutation, which can increase your risk of developing prostate cancer. You may benefit from screening for prostate cancer starting at an early age.

If you’re 55 to 69

It’s your choice whether or not to be screened for prostate cancer if you don’t have a family history of prostate cancer. Before making your decision, talk to your healthcare team about prostate cancer screening to fully understand the pros and cons. 

If you’re 70 or older

The USPSTF recommends that you shouldn’t be screened for prostate cancer. But other expert groups recommend screening for some people who are over 70.

What is a normal PSA level?

Most people without prostate cancer have a PSA level that’s less than 4 nanograms per milliliter of blood (ng/mL). 

If your PSA is higher than 4 ng/mL, it may be more likely that you have cancer:

• People with a PSA level of 4 ng/mL to 10 ng/mL have about a 25% chance of having prostate cancer. This is called the “borderline” range. 

• People with a PSA level greater than 10 ng/mL have a 50% or higher chance of having prostate cancer.

PSA levels can also vary by age, as seen in the table below.

Frequently asked questions

Why trust our experts?

Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

Reviewed by:

Brandon R. Mancini, MD, MBA, FACRO

Brandon R. Mancini, MD, MBA, FACRO, serves as medical director at BAMF Health in Grand Rapids, Michigan in the emerging field of theranostics. His primary clinical focus is on the treatment of people with metastatic prostate and neuroendocrine cancers.

Our editorial standards

Meet our experts