Screening check
Prostate cancer screening: when should I think about a PSA test?
Unlike most cancer screening, a PSA test is a choice to make with your doctor, not a routine test. Your age, race and family history change when that talk should start. Check where you stand in under a minute.
About you
For men and anyone else with a prostate. Nothing you enter leaves this page.
What you will see
What each guideline says for your age and risk, when the American Cancer Society says to start the conversation, and how often it suggests retesting if you enter a PSA result.
Educational only, not medical advice. Screening decisions are made with your doctor.
Source
US Preventive Services Task Force, 2018 recommendation (still the current final version; an update is in progress). American Cancer Society prostate cancer early detection guideline.
Validated in
Men without symptoms and without a previous prostate cancer diagnosis (USPSTF 2018).
Limits
Not for anyone with urinary symptoms or other signs of illness. It does not interpret a PSA result or estimate your personal cancer risk.
What the guidelines say
| Age | USPSTF 2018 | American Cancer Society |
|---|---|---|
| 40 to 54 | No recommendation for this age | Start the conversation at 50 (average risk), 45 (higher risk) or 40 (even higher risk) |
| 55 to 69 | An individual decision after talking through benefits and harms (grade C) | An informed decision with your doctor |
| 70 and older | Recommends against PSA screening (grade D) | Do not offer screening if life expectancy is under 10 years |
Sources: USPSTF (USPSTF 2018), American Cancer Society (ACS).
Who is at higher risk
The American Cancer Society counts African American men and men with a father or brother diagnosed before 65 as high risk, and says they should start the conversation at 45. Men with more than one close relative diagnosed at an early age are at even higher risk and should start at 40 (ACS).
Based on the available evidence, the USPSTF says it could not make a separate recommendation for Black men or for men with a family history. It says doctors should tell them about their higher risk of developing and dying of prostate cancer and about the benefits and harms of screening (USPSTF 2018).
Benefits and harms, in numbers
The USPSTF estimated what happens when 1,000 men aged 55 to 69 are offered PSA screening over about 13 years (USPSTF 2018):
| Out of 1,000 men offered screening | Number |
|---|---|
| Avoid dying of prostate cancer | 1.3 |
| Avoid cancer that has spread (metastatic) | 3 |
| Get at least one positive PSA result | 240 |
| Have one or more prostate biopsies | 220 |
| Are hospitalized for a biopsy complication | 2 |
| Are diagnosed with prostate cancer | 100 |
The USPSTF also says 20% to 50% of men diagnosed through screening may be overdiagnosed, meaning the cancer would never have caused symptoms or death. About 1 in 5 men who have the prostate removed develop long-term urinary incontinence and 2 in 3 have long-term erectile dysfunction, and up to 1 in 6 men treated with radiation have long-term bothersome bowel symptoms (USPSTF 2018). That trade-off is why the decision is a personal one.
How often to test
If you choose screening, the American Cancer Society says men with a PSA under 2.5 ng/mL may only need retesting every 2 years, and men with a PSA of 2.5 or higher should be retested yearly (ACS). A digital rectal exam may also be part of screening (ACS).
Common questions
What age should men get a PSA test?
There is no single age. The USPSTF says it is an individual decision from 55 to 69 (USPSTF 2018). The American Cancer Society says to start the conversation at 50, or at 45 or 40 for men at higher risk (ACS).
What is the lifetime risk of prostate cancer?
About 11% of men will be diagnosed with prostate cancer in their lifetime, and about 2.5% will die of it, according to the USPSTF (USPSTF 2018).
Should I stop at 70?
The USPSTF recommends against PSA screening from 70 (USPSTF 2018). Talk to your doctor if you have been screened before and are unsure what to do next.
I have trouble urinating. Should I wait for screening?
No. Screening is for men without symptoms. Urinary problems or other changes should be checked by a doctor at any age.
Also see the colon cancer screening check, the lung cancer screening check and the testicular cancer screening check.
Sources
- US Preventive Services Task Force. Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(18):1901-1913. www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening
- American Cancer Society. American Cancer Society Recommendations for Prostate Cancer Early Detection. www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/acs-recommendations.html
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-10-30. Spotted an error? See About.