Prostate cancer is the second most common cancer in men in the United States and is more common in older men than younger men. While this article focuses specifically on prostate cancer screenings and questions you should ask your doctor, you can read more information about prostate cancer in our article on it. This article covers what prostate cancer is, how it develops, the basics of screening for it, and more.

Depending on your age and other factors, your doctor may recommend getting screened (tested) for prostate cancer. Most commonly, prostate cancer screenings are completed for those aged 55 and up, but if you are younger than this and have concerns, predisposition, or other personal reasons, you should talk to your doctor about your risks and the possibility of being screened for it.

If you’re age 55 to 69: 

The decision to get screened is a personal choice that you can make after talking with your doctor, and you might decide that you’re okay with the risks of getting screened, or you might decide the risks aren’t worth it. Together, you and your doctor can decide what’s right for you and evaluate your options.

If you’re age 70 or older:

Prostate screening isn’t recommended because the risks outweigh the benefits for most men in this age range, and this is true even if you’re at a higher risk for prostate cancer. However, if you have questions about prostate cancer, talk to your doctor. Many men have questions about prostate cancer screening. The information below can help you start a conversation with your doctor or nurse about the risks and benefits of screening.

What is the prostate?

The prostate is a gland that helps make semen (the fluid that carries sperm). It’s located below the bladder and in front of the rectum.

Who is at risk for prostate cancer?

Any man can get prostate cancer. But the risk is higher for men who:

• Those of older age. Your risk for developing prostate cancer increases as you age and is most seen in patients above the age of 50.  
• For unknown reasons, black people show higher rates of developing prostate cancer than all other racial groups. In addition, black people show higher rates of developing aggressive or more advanced forms of it.  
• Family history plays a crucial role. If a blood relative of yours, such as a parent or sibling, has been diagnosed with prostate cancer, you may be at increased risk.
• If you have a family history of genes that are associated with breast cancer (BRCA1 or BRCA2) or a family history of breast cancer, your risk for prostate cancer is also elevated.  

Screenings

Two types of screenings exist.  

The digital rectal exam, typically conducted as part of a routine physical exam, is used to identify any abnormalities with the texture of the prostate gland, such as its size or shape. This exam involves the doctor or nurse physically examining the inside of the rectum with a lubricated, gloved hand, to feel for any abnormalities. If the doctor determines there is a texture abnormality, you may need further testing.  

The prostate-specific antigen test, or the PSA test, is another method of prostate cancer screening. A blood sample is taken from the patient via a vein in the arm, and it is analyzed for prostate-specific antigen, PSA. This antigen is naturally produced by the prostate gland, and it is normal for this to be found in the bloodstream in low amounts. However, if it is found that your blood levels show elevated levels of PSA, this is an indicator of prostate infection, inflammation, enlargement, or cancer. 

If one of these screenings produces an abnormality, your doctor may complete further tests to determine if you have prostate cancer or not.  

Why isn’t prostate screening recommended for all men?

All screening tests have both risks and benefits. Here are some things to consider when deciding whether to get screened:

• Many prostate cancers grow so slowly that men won’t have symptoms or die from the cancer
• Treatment for prostate cancer can cause problems like erectile dysfunction (impotence) or loss of bladder control
• Prostate screening sometimes says you have cancer when you really don’t, and follow-up tests can cause problems like infections

What do I ask the doctor?

When you visit the doctor, it helps to have questions written down ahead of time. You can also ask a family member or friend to go with you and take notes.

Print this list of questions and take it to your next appointment.

• Am I at high risk for prostate cancer?
• Are there things I can do to lower my risk for prostate cancer?
• What are the risks and benefits of prostate cancer screening and treatment for me?
• Are there any warning signs or symptoms of prostate cancer to look out for?
• If the results of the screening test show that I might have prostate cancer, what are my options for diagnosis and treatment?