Prostate cancer often causes no problems because it grows slowly and stays in the prostate gland. But some types of prostate cancer spread quickly and need treatment.
Regular screening can lower your risk of dying from prostate cancer by finding cancer early, when it’s easier to treat.
Screening can also find cancer that grows slowly. This kind of cancer may worry some people and cause them to get treatment they may not need.
Other people may feel comfortable managing this low-risk prostate cancer without aggressive treatment. They choose a careful monitoring program called active surveillance. It’s a form of treatment and is not the same as having no treatment. If your care team sees changes in your prostate or tumor they may recommend you stop active surveillance. You may start another treatment, such as surgery or radiation therapy.
A prostate-specific antigen (PSA) test is a simple blood test. You should only consider getting a PSA if you’re comfortable managing low-risk prostate cancer with active surveillance. You may need a biopsy if the PSA is high. A biopsy is a procedure to get a sample of cells or tissue to examine.
Read more about prostate cancer.
What is the screening test for prostate cancer?
Screening for prostate cancer is done with a simple blood test called a prostate-specific antigen (PSA) test. This test measures the level of a protein made by cells in the prostate gland in your blood. PSA levels rise if there’s a problem with your prostate. It’s normal to have a low level of PSA.
What is my risk for prostate cancer?
Knowing your risk for getting prostate cancer can help you decide whether screening is right for you. A risk factor is anything that increases your chance of getting a disease, such as cancer.
Anyone with a prostate gland can get prostate cancer. This includes people of all genders who were assigned male at birth, such as transgender women. If you’re a transgender woman and had gender-affirming surgery, you probably still have a prostate gland. Talk with your healthcare provider about being screened.
Age is the biggest risk factor for prostate cancer. The older you are, the more likely you may get prostate cancer. Other factors that raise your risk for prostate cancer are:
- Having a close relative, such as a parent or sibling, with prostate cancer. This is very true if they were diagnosed before age 60.
- Having changes (mutations or variants) in certain genes passed down from a parent. These genes include BRCA1 or BRCA2 genes, HOXB13, and ATM. Our clinical genetics experts are available to help you understand your level of risk. They can recommend screening that’s right for you.
- Your race. Prostate cancer affects the Black community at a higher rate than any other race in the United States.
MSK’s screening guidelines for prostate cancer
Talk with your healthcare provider about your risk for prostate cancer and when screening is right for you. If you decide to have prostate cancer screening, MSK recommends you follow these guidelines. They apply to people at average risk who are expected to live 10 years or longer.
The guidelines may be different from those of other groups of experts. You and your healthcare provider may choose other options for having a prostate biopsy or your screening schedule.
If you’re age 45 to 49
Consider talking with your provider about the benefits and risks of having a baseline PSA. If you choose to get a test and your PSA level is:
- 3 ng/mL or higher. Talk with your healthcare provider about having a repeat PSA. If that PSA is still above 3 ng/mL, you should consider a secondary test, imaging, or a biomarker. This can tell us if you need a prostate biopsy.
- Between 1 and 3 ng/mL. Have another PSA test in 2 to 4 years. Have it in 2 years if your PSA is closer to 3, and in 4 years if it’s closer to 1.
- Less than 1 ng/mL. Have another PSA test between the ages of 51 and 55.
If you’re age 50 to 59
Consider having your PSA level checked. If you choose to get a test and your PSA level is:
- 3 ng/mL or higher. Talk with your healthcare provider about having a repeat PSA. If that PSA is still above 3 ng/mL, you should consider a secondary test, imaging, or a biomarker. This can tell us if you need a prostate biopsy.
- Between 1 and 3 ng/mL. Have another PSA test in 2 to 4 years. Have it in 2 years if your PSA is closer to 3, and in 4 years if it’s closer to 1.
- Less than 1 ng/mL. Have another PSA test at age 60.
If you’re age 60 to 70
Consider having your PSA level checked. If you choose to get a test and your PSA level is:
- 3 ng/mL or higher. Talk with your healthcare provider about having a repeat PSA. If that PSA is still above 3 ng/mL, you should consider a secondary test, imaging, or a biomarker. This can tell us if you need a prostate biopsy.
- Between 1 and 3 ng/mL. Have another PSA test in 2 to 4 years. Have it in 2 years if your PSA is closer to 3, and in 4 years if it’s closer to 1.
- Less than 1 ng/mL. No more screening is recommended.
If you’re age 71 to 75
Talk with your healthcare provider about whether to have a PSA test. This decision should be based on past PSA levels and your health. You should only keep testing PSA if it’s high (above 3 ng/mL) and your health is good.
If you’re age 76 and older
Talk with your healthcare provider about whether to have a PSA test. This decision should be based on past PSA levels and your health. In this age group, a PSA test is very rarely helpful.
