Prostate Cancer | Pros & Cons of PSA Testing

Last Updated June 2023 | This article was created by editorial staff and reviewed by Kyle Bradford Jones, MD, FAAFP

Prostate cancer, the growth of abnormal cells in a man’s prostate gland, is a leading cause of death in men. Your doctor can perform a screening. The screening includes a prostate-specific antigen (PSA) test (blood test) to check the PSA level in your blood. PSA is a substance produced by the prostate gland. A high PSA level may indicate a prostate problem. A digital rectal exam (DRE) is still widely used by many physicians. This is a physical screening in which your doctor inserts their gloved finger into your rectum to feel the size of your prostate. If you doctor needs more information, they may use imaging tools, such as ultrasound or MRI to get a more detailed look of your prostate.

Path to improved health

The goal of prostate screenings is to find cancer early. Cancer is easier to treat and more likely to be cured if it is caught early.

However, most cases of prostate cancer are not aggressive. More men have a slow-growing form of prostate cancer. This means they may not have symptoms or even require treatment. This approach is called “watchful waiting” or “active surveillance.” Prostate cancer treatment can have long-term side effects. These include loss of bladder control and erectile dysfunction. There is a rare chance of problems occurring in surgery to get a biopsy. This is the only way to confirm a prostate cancer diagnosis.

PSA test results aren’t always accurate or are “false positives.” This means that the PSA test result suggests that you might have cancer when you do not. A false-positive test result can lead to unneeded tests, such as a biopsy, and side effects from testing. It also causes worry for you and your family.

For these reasons, the American Academy of Family Physicians and U.S. Preventive Services Task Force have issued clinical recommendations. For men 55 through 69 years of age, they do not recommend routine PSA screening. Instead, they recommend having a conversation with your doctor about the risks and benefits of periodic screening. They do not recommend PSA screening for prostate cancer in men 70 years of age and older.

Other organizations have different screening recommendations. These include the American Cancer Society and the American Urological Association. Their guidelines depend on your age and state of health.

Things to consider

Ultimately, the decision to be screened for prostate cancer is between you and your doctor. Talk to them about your specific concerns. They can weigh the pros and cons with your personal health and risk factors.

Doctors and scientists perform ongoing and new research. These studies, or clinical trials, help to learn more about the benefits and risks of prostate cancer screening. Ask your doctor about the most recent study results. Try to stay up to date on new progress in prostate cancer screening and treatment.

Questions to ask your doctor

  • How do I know if prostate screening is right for me?
  • What are the symptoms of prostate cancer?
  • If I have a high level of PSA, what problems could I have?


American Academy of Family Physicians: Clinical Preventive Service Recommendation: Prostate Cancer

American Cancer Society: Recommendations for Prostate Cancer Early Detection

American Urological Association: Prostate Cancer Guidelines

National Cancer Institute: Prostate Cancer—Patient Version

National Institutes of Health, MedlinePlus: Prostate Cancer

U.S. Preventive Services Task Force: Prostate Cancer: Screening


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