What You Need to Know About Prostate Cancer Testing

Prostate cancer is the most common non-skin cancer in American men. But when to get screened for it isn’t an easy decision. Talking with your doctor can help you choose what’s best for you.

Testing Recommendations

The U.S. Preventive Services Task Force recommends  that men between the ages of 55 and 69 talk to their doctors about what prostate cancer screening choice is right for them. The task force recommends against routine screening for men age 70 and older.

The recommendations apply to all adult men who have no signs or symptoms of prostate cancer and who have never been diagnosed with the disease. It also includes men at increased risk, such as African American men and men with a family history of prostate cancer.

Sometimes prostate cancer has no symptoms. When there are symptoms, they can include:

• Trouble starting or stopping the flow of urine
• Passing urine more often during the day or getting up many times during the night to pass urine
• A frequent, urgent need to pass urine, even when there is only a small amount
• Less urine flow
• Burning when you pass urine
• Chills and high fever
• Low back pain or body aches
• Pain low in the belly, groin or behind the scrotum
• Sexual problems and loss of sex drive

Tell your doctor if you have these symptoms.

Keep in mind that men can have prostate changes that cause symptoms like those above but aren’t because of cancer. For example, as a man ages, the prostate tends to grow in size. That can decrease urine flow.

Screening Tests

The most common screening test for prostate cancer is the prostate-specific antigen (PSA) blood test. PSA is made by cells in the prostate gland. It is made by both normal cells and cancer cells. A higher level of PSA may indicate that cancer is present.

PSA tests can help find cancer early, when treatment is most effective. But it can have some drawbacks.

For some men, the downsides of prostate cancer screening outweigh the potential benefits. The Mayo Clinic says the downsides include:

• Raised PSA levels may stem from an infection or benign prostate enlargement instead of cancer. So the test may seem to indicate cancer when you don’t have it. This happens often.
• Some prostate cancers don’t make much PSA. So the test result might show that you don't have prostate cancer when you do.
• Follow-up tests can cause a lot of stress. They can be invasive and costly.
• Knowing you have a slow-growing cancer that does not need treatment can cause worry and stress.

Talk to your doctor about the benefits and risks and make an informed choice.

Can You Lower Your Risk?

Most risk factors for prostate cancer, like age, family history and ethnicity, can’t be changed. And whether things like weight, activity levels and diet can significantly lower your risk for prostate cancer isn’t entirely clear.

The American Cancer Society  says these healthy lifestyle choices may help lower your risk:

• Keep a healthy weight.
• Eat healthy foods like fruits, vegetables and whole grains. Limit dairy, red and processed meat, sugary drinks, and highly processed foods.
• Get regular physical activity.

Sources: Should You Get Screened for Prostate Cancer?,  Centers for Disease Control and Prevention, 2022; Prostate Cancer,  National Cancer Institute; Prostate cancer screening: Should you get a PSA test?,  Mayo Clinic, 2022; Prostate Cancer Causes, Risk Factors, and Prevention,  American Cancer Society

Originally published 7/27/2020; Revised 2022, 2023