Prostate cancer screening has long been debated among medical experts because while it can save lives, it can also lead to unnecessary treatments and serious side effects for cancers that may never become dangerous.
The primary screening tool for prostate cancer is the prostate-specific antigen, or PSA, blood test. The test measures PSA levels in the blood, with elevated levels potentially signaling the presence of prostate cancer.
Prostate cancer is one of the most common cancers affecting men. Some forms of the disease are aggressive and can spread rapidly. Detecting these cancers early through screening may allow for treatment before the cancer advances, potentially reducing deaths from the disease.
However, not all prostate cancers behave the same way.
Many prostate cancers grow very slowly and may never cause symptoms or become life-threatening during a man’s lifetime. When these slow-growing cancers are detected through screening, patients may choose treatment that could have been unnecessary. Treatments for prostate cancer can carry significant risks, including erectile dysfunction and urinary incontinence.
Another concern is that elevated PSA levels do not always indicate cancer. Non-cancerous conditions such as an enlarged prostate, prostate infections, or normal aging can also cause PSA levels to rise.
As a result, some men receive false-positive results that lead to additional testing, including prostate biopsies. These procedures can create anxiety and carry their own medical risks.
Recent research has renewed discussion about the value of screening. A 2026 review by Cochrane analyzed six large prostate cancer screening trials conducted in Europe and the United States. The review found that PSA screening likely reduces prostate cancer deaths, although the benefit appears modest.
According to the review, screening approximately 1,000 men may prevent about two prostate cancer deaths.
Because of the balance between potential benefits and risks, major medical organizations encourage men to make individualized decisions about screening in consultation with their healthcare providers.
The American Cancer Society recommends discussing screening at age 50 for men at average risk. Men considered at higher risk, including African American men and those with a father, brother or son diagnosed with prostate cancer before age 65, are encouraged to begin discussions at age 45. Men with multiple close relatives diagnosed at an early age may consider starting discussions as early as age 40.
The U.S. Preventive Services Task Force recommends that men ages 55 to 69 make individual decisions about screening after discussing potential benefits and harms with their physician. The group generally recommends against routine screening for men age 70 and older.
Health experts emphasize that there is no one-size-fits-all answer. Factors such as age, family history, race, overall health and personal preferences all play a role in determining whether prostate cancer screening is the right choice.
For many men, the decision comes down to balancing the possibility of detecting a life-threatening cancer early against the risk of finding and treating a cancer that may never have caused harm.
Sources
American Cancer Society. “Can Prostate Cancer Be Found Early?” https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/detection.html.
Cochrane Library. “Prostate-Specific Antigen (PSA) Test for Prostate Cancer Screening.” https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004720.pub4/full.
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