A prostate cancer outlook can be good when a person receives an early diagnosis from a doctor. Several prostate cancer screening tests are available for doctors to detect it.

Among males in the United States, prostate cancer is the most commonly diagnosed cancer. Experts estimate that there will be more than 268,000 new cases among males in the U.S. by the end of 2022.

Prostate cancer may occur more often in:

  • People assigned male at birth: The prostate is part of the male reproductive system.
  • Older adults: Doctors detect about 60% of the diagnoses in people who are more than 65 years old.
  • Non-Hispanic Black males: They may experience a higher chance of getting prostate cancer due to socioeconomic or health inequities.

If people receive a prostate cancer diagnosis early, the outlook can be good. But oftentimes, prostate cancer does not cause symptoms until it advances.

Several screening tests are available to help detect prostate cancer early. Read on to learn what tests exist, how well they work, and whether you might be a good candidate for prostate cancer screening.

The purpose of screening for prostate cancer is to help detect the cancer before you notice any symptoms. There are multiple screening tests that doctors might use, and often, doctors combine them.

Prostate-specific antigen test

Your prostate makes an enzyme called prostate-specific antigen (PSA) that doctors can detect with a blood test. Elevated PSA can be an indicator of prostate cancer.

High PSA can also occur due to several noncancerous conditions, so your PSA levels can’t definitively say whether you have prostate cancer.

Digital exam

A digital rectal exam (DRE) is a physical examination of your prostate gland. Using a lubricated, gloved finger, a doctor can directly feel your prostate through your rectum. They may be able to feel atypical growths or enlarged areas on your prostate that could indicate cancer.

Prostate cancer gene 3 RNA test

Prostate cancer gene 3 (PCA3) is a genetic marker that doctors can analyze with a urine test. PCA3 is more abundant in prostate cancer cells, but many other prostate conditions do not affect it.

Secondary screenings

Because screenings can lead to false positives, doctors will need a biopsy to confirm your diagnosis. However, biopsies can come with their own risks.

To avoid an unnecessary biopsy, a doctor may recommend a secondary screening first. This might include diagnostic imaging, such as an MRI or a transrectal ultrasound.

A doctor can usually perform a prostate cancer screening in an examination room at their office.

To complete a PSA test, a medical professional will take a blood draw and send it to a lab. A doctor can help you prepare for the blood draw. Results are usually available after a few days.

Similarly, a PCA3 test will require you to provide a urine sample. The doctor will send the sample to a lab and get the results back in a few days.

A DRE does not require a lab, so your doctor can provide immediate feedback.

In the early stages, prostate cancer usually doesn’t have any symptoms. By the time you notice symptoms, the cancer can advance, making treatment much more difficult.

Before screening became available, one of the most common ways people discovered their prostate cancer was paralysis after the cancer spread to the spine.

So, the main benefit of screening is the ability to detect the disease at an early stage when it is more easily and effectively treatable. Screening can reduce your risk of death from prostate cancer by 25% to 31%.

The U.S. Preventative Services Task Force (USPSTF), a nongovernmental expert advisory group, researched prostate cancer screening and found that there are some risks involved.

Some of these risks stem from the possibility that screening can provide false-positive results. For example, elevated PSA could be due to prostate cancer or other conditions.

A false-positive result could lead to mental health distress. Additionally, follow-up tests and biopsies come with their own risks and could lead to complications.

It’s also possible to receive false-negative screening results, meaning that the tests don’t indicate cancer even though you have it. It’s possible that this false sense of health could lead you to delay treatment even if you notice symptoms.

Healthcare professionals give PSA test results in nanograms per milliliter (ng/mL). Generally, if your PSA is greater than 2.5 ng/mL, you may be at a high risk of prostate cancer, while a result of 4 ng/mL or greater warrants further testing. It’s important to remember that PSA test results are not definitive and can vary from person to person.

Doctors also give PCA3 results as a score. Oftentimes, a score of 35 or greater is an indication that doctors need to perform further testing, but not all experts agree on this cutoff.

If you have a DRE result, the doctor can describe to you what they felt. Your prostate should be rubbery but firm. A healthy prostate has a smooth surface, and it shouldn’t be tender to the touch.

The USPSTF considers the risks and benefits of prostate cancer screening when making recommendations for males who are at an average risk of getting prostate cancer.

Based on current research, the USPSTF recommends that males between the ages of 55 and 69 discuss their individual risks and benefits to screening before deciding.

For many people, getting an early prostate cancer diagnosis is potentially lifesaving. But for others, the risks of the screenings and follow-ups could outweigh the potential benefits. For people ages 70 and older, the risk of screening may be higher than the benefits.

The American Cancer Society recommends beginning screening at 50 years old or as early as 45 or 40 years old if your risk of prostate cancer is higher.

Your doctor can help you decide if you’re a good candidate for prostate cancer screening.

If you just received a prostate cancer diagnosis, you probably have many questions, and you may think of more. It can be helpful to write them down in one place so you don’t forget them when you speak with your doctor.

You might want to ask about your:

  • cancer’s stage, grade (Gleason score), and spread
  • treatment options
  • costs and whether your insurance might cover them

It will also be important to rely on a close, trusted support network. Consider the use of therapy or support groups to help navigate your emotions.

And, if it’s medically safe, light exercise, time outdoors, and participating in activities you enjoy are all important for your overall well-being.

After doctors inform you of the potential risks and benefits of prostate cancer screening, you may still have other questions.

Is a prostate exam safe?

All medical procedures involve some level of risk, but experts generally consider the procedures to screen for prostate cancer, such as PSA blood tests, PCA3 urine tests, and DREs, safe.

At what age should you get your prostate checked?

If you decide to undergo prostate cancer screening, the age range experts recommend is from 55 to 69 years old.

For people who might be at a higher risk — African Americans and those with a parent or sibling with prostate cancer — screenings can begin at 45 years old, or as early as 40 years old.

How often should you get a prostate exam?

Having a doctor examine your prostate every 2 years is usually sufficient. If you’re at a high risk, your doctor may recommend annual screening.

Prostate cancer is often asymptomatic, so screening is the best way to detect it early.

Screening tests are not definitive. You may need multiple tests or follow-ups to determine your risk of prostate cancer. You can only get a diagnosis after a biopsy.

Before undergoing prostate cancer screening, ask a healthcare professional about the potential risks and benefits so you can make an informed decision.