Prostate Cancer Screening and the PSA Test: What Men Should Know

What is the PSA test?

PSA stands for prostate-specific antigen, a protein made by the prostate gland. A PSA test measures the level of this protein in the blood. Higher levels can be a sign of prostate cancer, but they can also be caused by an enlarged prostate, an infection, recent procedures, or other non-cancerous reasons. Because of this, an elevated PSA does not diagnose cancer; it is a signal that more evaluation may be needed.

Who should consider PSA screening, and when?

The USPSTF recommends that men ages 55 to 69 make an individualized decision about PSA-based screening in consultation with their clinician. The American Urological Association supports offering PSA screening with shared decision-making, and notes that a baseline PSA is reasonable starting around ages 45 to 50, with consideration from ages 40 to 45 for men at higher risk, including Black men and men with a strong family history of prostate cancer.

• Ages 55 to 69: shared decision with your clinician.
• Ages 70 and older: routine screening is not recommended.
• Higher-risk men may begin the conversation earlier.
• A single discussion is not a commitment to annual testing.

What happens after an elevated PSA result?

An elevated PSA is followed by more discussion and testing, not automatically by a biopsy. Your provider will consider the specific number, how it compares with prior results, your age, and your risk factors. Options may include repeating the test, additional blood or imaging studies, or referral to a urologist. The goal is to identify cancers that matter while avoiding unnecessary treatment for slow-growing disease that may never cause problems.

Why is shared decision-making important?

Prostate cancer often grows slowly, and many men with it die of other causes first. Screening can find cancer early, but it can also lead to biopsies and treatments that carry side effects such as urinary, bowel, or sexual problems for cancers that may never have caused harm. That is why guidelines frame screening as a preference-sensitive choice: the right answer depends on your values, your health, and your family history.

• Screening benefit: earlier detection and potentially lower risk of dying from prostate cancer.
• Screening harms: false alarms, unnecessary biopsies, and treatment side effects.
• Your preferences and overall health matter as much as the numbers.

How does prostate screening fit into primary care?

TruHealth incorporates prostate screening discussions into routine checkups, where they can be considered alongside blood pressure, cholesterol, diabetes screening, and other preventive care. If you are in the age range where screening is a reasonable option and you have not discussed it recently, a checkup is a simple way to start the conversation.