Cancer screenings are tests that doctors can do to spot cancer before symptoms arise or before it becomes more advanced. Doctors perform prostate exams to screen for abnormalities.
The prostate gland secretes a liquid found in semen, the fluid that carries sperm. The prostate is located just below the urinary bladder in front of the rectum. The urethra passes from the urinary bladder through the middle of the prostate gland.
As men age, the prostate can become enlarged and start causing issues, including prostate cancer.
In this article, we talk about prostate exams for people assigned male at birth. Here, we use “men” to reflect a term that has been historically used to gender people. It’s important to note that not everyone assigned male at birth identifies with the label “man.”
While we aim to create content that includes and reflects the diversity of our readers, specificity is key when reporting on research participants and clinical findings.
A prostate screening can help your doctor find prostate cancer early, but you’ll need to decide if the benefits of the exam outweigh the risks. Have a discussion with your doctor about prostate cancer screenings.
The U.S. Preventive Services Task Force (USPSTF) now recommends that men ages 55 to 69 decide for themselves whether to undergo a prostate-specific antigen (PSA) screening test, after talking it over with their doctor.
It recommends against screening for men at or above age 70.
The Prostate Cancer Foundation recommends that men practice precision screening, and consult with their doctor to come up with a personal prostate cancer screening plan that’s right for them.
When to start this conversation depends on age and risk factors that may increase a man’s risk of prostate cancer. Here are the general recommendations:
- Age 40: men who have a family history of prostate or other cancers in a first-degree relative, are Black, or have known genetic mutations that may increase the risk of cancers (such as BRCA1 or BRCA2 mutation)
- Age 45: men with no known risk factors
PSA screening should be considered carefully based on life expectancy, existing conditions, family history, and ethnicity. Side effects from some treatments can lessen life expectancy and quality of life.
Speak with your doctor about a prostate exam if you’re experiencing symptoms of a prostate problem, such as frequent or painful urination or blood in your urine.
After this discussion, if you decide to get a prostate cancer screening, the ACS recommends getting a prostate-specific antigen (PSA) blood test.
A digital rectal exam (DRE) may also be a part of your screening.
If the results of your DRE are normal, your next steps will depend on your age, health, and PSA levels. If no suspicion for prostate cancer is found during a regular screening, the time between future screenings depends on the results of the PSA blood test. The
- Men with a PSA level of less than 2.5 nanograms per milliliter (ng/mL) may only need to be retested every 2 years.
- Men with a PSA level of 2.5 ng/mL or greater should be screened annually.
This is because prostate cancer screenings have both risks and benefits.
Because there are risks (such as overdiagnosis) that may outweigh the benefits, the USPSTF recommends against prostate screening with blood tests for men ages 70 and above. However, as with any test, discuss with your doctor if this is appropriate for you.
Early detection of some types of cancer can make it easier to treat and improve your outlook.
Since the 1990s, the risk of death from prostate cancer in the United States has
If you undergo a prostate cancer screening, your doctor will likely order a blood test, so inform the person drawing your blood if you’re prone to dizziness.
Your doctor may ask you to sign a consent form before performing a cancer screening.
You can get a prostate exam easily and quickly at your doctor’s office. Generally, for prostate cancer screenings, your doctor will take a simple blood test.
PSA blood test
A PSA blood test measures PSA level in nanograms per milliliter. Higher PSA levels indicate a higher risk of prostate cancer.
A small amount of blood is taken from a vein in the arm and used to determine the level of PSA.
Your doctor might also choose to perform a DRE, or digital rectal exam. Before performing this exam, your doctor will ask you to change into a gown, removing your clothing from the waist down.
During a DRE, your doctor will ask you to bend over at the waist or lie on the exam table in a fetal position, with your knees to your chest. They will then insert a gloved, lubricated finger into your rectum.
Your doctor will feel for anything abnormal, such as bumps or hard or soft areas that might indicate a problem. Your doctor may also be able to feel if your prostate is enlarged.
A DRE can be uncomfortable, especially if you have hemorrhoids, but isn’t overly painful. It will last only a couple of minutes.
What happens if PSA is high?
A PSA level that’s elevated may indicate prostate cancer, but it may also indicate other conditions, such as benign prostate hyperplasia (BPH) or prostate infections. PSA levels can increase due to several factors, including age, infection, size of the prostate gland, and more.
If your PSA is high, your doctor may recommend another PSA test to confirm the number, and follow up with regular PSA tests and DRE exams to observe over time. If PSA continues to increase, your doctor might recommend additional testing and imaging.
A DRE is one of your doctor’s tools that can help them detect several prostate and rectal problems, including:
- prostate cancer
- abnormal masses in your rectum and anus
Your doctor will be able to tell immediately if there are any areas of concern that may warrant further testing.
The results of a DRE are either normal or abnormal, but doctors typically rely on several different tests to help them make a prostate cancer diagnosis.
If your doctor feels something abnormal during the DRE, they may recommend a PSA blood test, if they haven’t done so already.
If you have an abnormal DRE and high PSA levels, your doctor may recommend additional tests, including:
- transrectal ultrasound
- prostate biopsy
- MRI scan
Should I poop before a prostate exam?
You don’t need to poop or change your bathroom habits before a prostate exam. If you need to use the bathroom, or if using the bathroom before the exam will make you more comfortable, you can.
How painful is a prostate exam?
A prostate exam might be uncomfortable, but it is not known to be painful, and there should not be lasting discomfort following the exam.
You might experience the urge to urinate or brief discomfort.
Can I check my own prostate?
It is not recommended that you try to check your own prostate.
The prostate is an internal gland, and performing a self-examination could cause harm. For your safety, the exam should be performed by a licensed healthcare professional.
Additionally, a professional will be better able to assess if there is a reason for concern.
If you have a family history of cancer, are Black, or have known genetic mutations, begin the conversation with your doctor to see if screening for prostate cancer is a good idea starting at age 40.
Even if you have no known risks, discuss testing with your doctor at age 45.
The exam will be performed at your doctor’s office, and it typically involves a simple blood test. When necessary, a DRE might be performed.
If either or both of your prostate cancer screening tests are abnormal, you and your doctor will discuss the next steps.
These next steps will depend on your age, general health, and family history. More invasive testing carries increased risk, which you will need to discuss with your doctor.