Prostate cancer screening

Prostate cancer screening is a personal choice that you should talk through with your doctor.

Rosa: Hi, I'm Rosa. Prostate screening is a personal choice. Let's go over the benefits and the downsides, so you can talk it through with your doctor.

The prostate is a small gland below the bladder in men and people assigned male at birth. Prostate screening uses a blood test called PSA, which stands for prostate-specific antigen. PSA is a protein made by the prostate. A high level can be a sign of cancer, but it can also come from an enlarged prostate, an infection, or other causes.

Prostate screening is a choice, not a must. Screening can find cancer early and may lower the chance of dying from prostate cancer for some men. But many prostate cancers grow so slowly that they would never cause harm. Finding them can lead to more tests, biopsies, and treatment that may cause problems with urine control or erections.

The U.S. Preventive Services Task Force (final advice from 2018) says men 55 to 69 should decide for themselves after talking with their doctor. It recommends against routine PSA screening at age 70 and older. The Task Force is working on an update.

The American Cancer Society says to start the talk at age 50 for men at average risk. Start at 45 for Black men and men whose father or brother had prostate cancer before age 65. Start at 40 for men with more than one close relative who had it at an early age. Because these groups differ, ask your doctor when to start the conversation.

If a PSA test is high, the next step is not always a biopsy. Your doctor may repeat the test, order an MRI (magnetic resonance imaging) of the prostate, or use other tests first. If a small, slow-growing cancer is found, many men choose active surveillance. This means watching the cancer closely and treating only if it changes.

PSA test

A blood test that measures prostate-specific antigen, a protein made by the prostate.

Digital rectal exam

A doctor feels the prostate with a gloved finger. It is sometimes done along with the PSA test.

Higher risk

Black men and men with a father or brother who had prostate cancer, especially at a young age.

Prostate MRI

A scan that can help decide whether a biopsy is needed.

Active surveillance

Watching a low-risk cancer with regular tests instead of treating it right away.

• Ask: Based on my age, race, and family history, when should I start thinking about screening?
• Ask: What are the good and bad sides of screening for me?
• Ask: If my PSA is high, what are the next steps?
• Tell your doctor about prostate, breast, ovarian, or pancreatic cancer in your family.
• Make the choice that fits your values. It is okay to take time to decide.

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.