Should I Get Screened for Prostate Cancer?

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 — including prostate cancer.

But here’s the tricky part. Because prostate cancer grows so slowly, many people with prostate cancer will never know they have it — unless they find it on a screening test. In other words, even if you have prostate cancer, it might grow so slowly that it won’t ever cause you problems. 

Read on for more information about prostate cancer screening, its pros and cons, and whether screening is right for you. 

How does prostate cancer screening work?

Prostate screening is done with a blood test, called a prostate-specific antigen (PSA) test. This test can tell how much PSA is in your blood. PSA is a substance your prostate makes. 

PSA can be higher in people with prostate cancer. PSA can also be high in other situations:

• You’ve recently had a certain type of medical procedure.

• You’re taking certain medications.

• You have an enlarged prostate.

• You have a prostate infection.

And PSA can be lower in people who take testosterone blockers (like feminizing hormones) or those who have obesity. You can read more in our GoodRx article about different things that can make your PSA level low or high.

Do I need a digital rectal exam to screen for prostate cancer?

You probably don’t need a digital rectal exam (DRE) — at least not until you’ve had a PSA test. 

A DRE is where a provider inserts a gloved finger into your rectum, to feel for lumps and bumps on your prostate. This can help them decide whether or not you might have prostate cancer. 

The U.S. Preventive Services Task Force no longer recommends a DRE as a screening test for prostate cancer. Providers sometimes still use it as a follow-up to PSA testing, especially if your PSA levels are “borderline” (meaning they’re only a little bit higher than normal). 

Your provider might also suggest a DRE to look for other problems, 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. 

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 recovery — especially if you have high-risk prostate cancer. 

So what are the downsides to prostate cancer screening? First, your PSA test results might not be accurate. As noted above, your PSA levels could be elevated for a reason other than cancer. This means that having a high PSA level could lead to more medical tests — like a prostate biopsy — that you don’t necessarily need. 

Second: Though prostate cancer screening can catch high-risk cancers, it can also find cancers that will not 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.

What are the symptoms of prostate cancer?

Many people with prostate cancer do not have any symptoms. 

If you do have prostate cancer symptoms, you might notice that you:

• Need to urinate more often

• Have a urine stream that’s weaker than usual, or starts and stops

• Feel like your bladder is still a little full after you urinate

• Feel pain or discomfort when you urinate or ejaculate

• Have blood in your urine or semen

• Have pain in your back or hips

I’m having symptoms. What should I do?

If you have any of these symptoms, talk to your healthcare provider. They can help decide whether to look for prostate cancer, or determine if another medical condition might be causing your symptoms.

At what age should I start prostate cancer screening?

There are different recommendations about when to start thinking about prostate cancer screening. If you don’t have any symptoms, most experts agree you should start talking to your provider when you reach middle age. 

If you do have symptoms, talk to your provider as soon as possible — no matter how old you are. 

Here’s what the U.S. Preventive Service Task Force currently recommends:

• If you’re 55 to 69: It’s your choice whether or not to be screened for prostate cancer. Before making your decision, talk to your doctor about prostate cancer screening to fully understand the pros and cons. Your provider can also help you understand how your family history and life experiences might affect your risk of getting prostate cancer. 

• If you’re 70 or older: You should not be screened for prostate cancer.

These screening recommendations only apply if you do not have prostate cancer symptoms, and you’ve never been diagnosed with prostate cancer. They still apply even if you have a higher risk for prostate cancer, based on your race or family history. 

What do my prostate cancer screening results mean?

Most people without prostate cancer have a PSA level that is 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 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.

But keep in mind: A PSA test alone cannot diagnose you with prostate cancer. It can only tell your provider whether or not to suspect prostate cancer. 

If your provider suspects prostate cancer, they may suggest you have a biopsy. A biopsy is a medical procedure that’s used to confirm (or rule out) prostate cancer.  

How can I encourage a friend or family member to get screened?

Educating yourself is a great way to be prepared for talking to friends and family about prostate cancer screening. 

Sharing trusted resources with friends and family can also be helpful — like articles here at GoodRx or from the Prostate Cancer Foundation. The CDC also has an interactive online feature where you can “talk to Nathan” about prostate cancer screening. 

Need more ideas? Check out our GoodRx guide on encouraging friends and family members to get screened for cancer. 

I’ve had prostate cancer in the past. Do I need to be screened?

Yes. If you’ve had prostate cancer, you will need to be screened again in the future. This is because prostate cancer can reoccur, even many years after treatment.

If you are a prostate cancer survivor, your provider will continue to closely monitor you. They’ll also help you put together a schedule for screening — for prostate cancer and other related cancers. How often you need to be screened depends on the stage of your cancer and how likely it’s to come back. 

Many providers recommend that survivors have PSA tests about every 6 months for the first 5 years after treatment, and at least yearly after that. Your provider may also suggest other screening tests — like a bone scan or other imaging. 

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:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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