Prostate cancer is one of the most common cancers in men, yet many don’t realize it often develops without symptoms. In fact, research shows that 80% of men are unaware that early-stage prostate cancer is typically asymptomatic. Recent data also reveals that despite years of decline, prostate cancer rates have been on the rise for the past decade. With these findings, many experts are suggesting updates to screening recommendations.

To help you better understand prostate cancer screening, we asked medical oncologists to explain risk factors and current guidelines.

What are the current screening guidelines for prostate cancer?

Medical oncologist Dr. Jacob Berchuck says, “[It’s a myth] that men will be symptomatic or have symptoms that they’re experiencing at the time of diagnosis. For most men, that’s actually not the case.” He adds, “The reason I think this is so important is that it really underscores and highlights the importance of prostate cancer screening.” Screening helps detect early prostate cancer when it’s asymptomatic, where there’s a “high chance of cure.”

Evidence-based guidance powered by NCCN Guidelines®

Personalized treatment plans shaped by the latest oncology standards—tailored to your diagnosis.

Get started

View your personalized treatment plan in the Outcomes4Me app

Use your diagnosis to unlock personalized NCCN Guidelines®-aligned recommendations.

Continue in app

Current screening guidelines are quite vague and can be hard to navigate. The American Cancer Society recommends having an informed discussion with your healthcare provider to assess the benefits and risks of screening, but what exactly does that look like? Before the conversation, UCLA’s Dr. Wayne Brisbane recommends assessing family history and asking relatives about cancer diagnoses that have occurred in the family. This helps your doctor determine your risk level and make an informed decision. If you decide to undergo screening, your doctor will order a PSA test.

What is a PSA test? 

PSA stands for prostate-specific antigen. Dr. Berchuck explains, “It’s a simple blood test that turns around in the lab within a couple of hours. It’s basically a test for a protein that’s only made by prostate cells. You can expect that as prostate cancer grows, and as those cells expand, that protein will go up, and we can detect that in the blood. Now it’s not a perfect test. I want to be very clear about that.” 

Genitourinary oncologist from Dana-Farber Cancer Institute Dr. Atish Choudhury shares that PSAs can be elevated for reasons that aren’t cancer. “People who have an enlarged prostate, something called benign, prostate hypertrophy might have slightly higher PSA levels than people who don’t have an enlarged prostate. Also, there can be some temporary inflammation of the prostate that comes and goes and makes the PSA levels actually fluctuate.” By solely relying on PSA alone, there are concerns of overtreatment, false positives, and unnecessary procedures.

Even with these concerns, experts agree that it’s important to monitor PSA levels. Dr. Brisbane emphasizes that PSA is “one of the most powerful screening tools.” He says, “It’s very complex. I like to think of it as a thermometer for the prostate. Just like, if you were to sleep or exercise, your temperature would be different.” 

What does this mean for you? 

Understanding your risk factors plays a big role in guiding you and your care team’s decision on prostate cancer screening. Dr. Berchuck notes that age is a major risk factor. “We’ve learned a lot over the last decade or so about risk factors for developing prostate cancer. Age is the biggest one. This is a disease of older men. Now, that’s not to say men in their fifties don’t get prostate cancer, but generally speaking, with every decade, prostate cancer risk increases.”

In addition to age, Black men and men who have a family history of prostate cancer are considered to be at a high risk for prostate cancer. Routine PSA testing in their forties may be recommended for these populations. Dr. Berchuck says, “Prostate cancer is actually one of the most heritable diseases. Family history is a major risk factor.” That’s why Palomar Health’s Dr. Hardeep Phull strongly encourages families to communicate and talk about their health and “inform future generations.” He acknowledges that while it can be a tricky topic to bring up, it’s critical to understand your family’s health history to help you and your loved ones be proactive about early detection.

Are there ways to reduce the risk of prostate cancer?

Although there aren’t any dietary modifications that clearly reduce the risk of prostate cancer, Dr. Berchuck highlights the importance of maximizing health and longevity. “I really focus on the common-sense things. If you smoke cigarettes, stop smoking. If you drink alcohol, do it in moderation. If you don’t exercise, start exercising; if you exercise, do a little bit more. Be mindful of your diet. [Do the] things that we know are associated with good health.” 

Don’t be afraid to discuss the screening process with your doctor. It should be personalized to your health, risk factors, and values. 

As always, if you would like to connect with an Outcomes4Me oncology nurse practitioner at no charge through the Outcomes4Me app, just use the “Ask Outcomes4Me” button.