How do you screen for prostate cancer?

Screening to detect prostate cancer may include a combination of the following: Prostate Specific Antigen (PSA) is a blood test used to screen for prostate cancer. Digital rectal exam (DRE) involves the doctor inserting a gloved, lubricated finger into the rectum to feel the prostate gland for enlargement or lumps. Multiparametric MRI (mpMRI) is a special type of imaging that can create a more detailed map of the prostate. Although a newer type of imaging, mpMRI is being used more for people at high risk for aggressive prostate cancer.

What are the benefits and risks of prostate screening?

Although the tests for prostate cancer detection are not invasive, it's important to weigh the benefits and risks of prostate cancer screening. Risks associated with overscreening Many experts worry that routine prostate screening in average-risk men can lead to more harm than good. This is because most prostate cancers grow very slowly and are unlikely to spread. When prostate cancer screening finds an abnormality, it may lead to a biopsy—an invasive test that removes a piece of tissue and checks it for cancer. Detecting and treating these slow-growing cancers may not improve health outcomes, while biopsy or treatment can lead to discomfort and side effects. Benefits of screening in high-risk individuals Some prostate cancers can be very aggressive, spreading to other organs and increasing the risk of death. Finding these cancers early through screening may help men live longer. These aggressive cancers are more common in: Black people people with inherited mutations in BRCA1 and BRCA2 and possibly other mutations linked to prostate cancer (note: more research is needed to determine if mutations in other genes cause more aggressive cancers) people with a family history of young-onset or aggressive prostate cancer Other factors that affect the benefits and risks of prostate cancer age overall health lifetime risk for prostate cancer risk for developing aggressive disease personal preferences Bottom line Most experts agree that people should have a discussion with their doctor about prostate cancer screening, which includes: their risk for developing prostate cancer their risk for developing aggressive disease the benefits and harms of prostate cancer screening compared to not screening Most experts feel that the benefits outweigh the harms for people at high risk for aggressive cancer. See below for expert guidelines.

What are the signs of prostate cancer?

All people at high risk for prostate cancer should be educated on the possible signs. However, prostate cancer may not cause any symptoms, especially in its earliest stages. You should report any of the following symptoms to your doctor: problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night blood in the urine or semen People with more advanced prostate cancer may develop the following symptoms (note: these symptoms do not necessarily mean you have cancer; other conditions can cause the signs listed below): trouble getting an erection pain in the hips, back or other bones weakness or numbness in the legs or feet loss of bladder or bowel control weight loss fatigue

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Early Detection of Prostate Cancer

Q: What is prostate cancer screening?

Screening for prostate cancer uses tests to try to catch cancer in its early stages, when it is most treatable. Many prostate cancers are slow growing, but some are more aggressive and can be life-threatening. The earlier that aggressive prostate cancer is found, the better a person’s chance of surviving it.

Q: What happens if there is an abnormal finding?

If the prostate feels abnormal on exam, or the PSA is high or rising over time, doctors may order a biopsy of the prostate. Doctors may also order imaging tests, such as MRI or additional biomarker tests.

Q: Prostate screening guidelines for average-risk people

There are several different guidelines for prostate cancer screening in people of average risk. All of the guidelines include having a conversation with your doctor about your risk for prostate cancer and the benefits, risks and limitations of screening using PSE testing and DRE. The recommended frequency of screening depends on whether the PSA results are low or slightly elevated. See the table below for more details.

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What is cancer screening?

Screening for cancer uses tests to try to catch cancer in its early stages, when it is most treatable. Many cancers are slow growing, but some are more aggressive and can be life-threatening. The earlier that aggressive cancer is found, the better a person’s chance of surviving it.

Types of prostate screening

When an abnormality is found

Benefits and harms of screening

Signs of prostate cancer

Guidelines for high-risk people

Guidelines for average-risk people

Research opportunities

More resources

How do you screen for cancer?

Screening to detect cancer may include a combination of the following:

Specific Antigen () is a blood test used to screen for cancer.
Digital rectal exam (DRE) involves the doctor inserting a gloved, lubricated finger into the rectum to feel the gland for enlargement or lumps.
() is a special type of imaging that can create a more detailed map of the . Although a newer type of imaging, is being used more for people at high risk for aggressive cancer.

Prostate Cancer Genetics: Experts Discuss Risk, Screening and Treatment

What happens if there is an abnormal finding?

If the feels abnormal on exam, or the is high or rising over time, doctors may order a biopsy of the . Doctors may also order imaging tests, such as or additional tests.

What are the benefits and risks of screening?

Although the tests for cancer detection are not invasive, it's important to weigh the benefits and risks of cancer screening.

Risks associated with overscreening

Many experts worry that routine screening in average-risk men can lead to more harm than good. This is because most cancers grow very slowly and are unlikely to spread. When cancer screening finds an abnormality, it may lead to a biopsy—an invasive test that removes a piece of tissue and checks it for cancer. Detecting and treating these slow-growing cancers may not improve health outcomes, while biopsy or treatment can lead to discomfort and side effects.

Benefits of screening in high-risk individuals

Some cancers can be very aggressive, spreading to other organs and increasing the risk of death. Finding these cancers early through screening may help men live longer. These aggressive cancers are more common in:

Black people
people with inherited mutations in and and possibly other mutations linked to cancer (note: more research is needed to determine if mutations in other genes cause more aggressive cancers)
people with a family history of young-onset or aggressive cancer

Other factors that affect the benefits and risks of cancer

age
overall health
lifetime risk for cancer
risk for developing aggressive disease
personal preferences

Bottom line

Most experts agree that people should have a discussion with their doctor about cancer screening, which includes:

their risk for developing cancer
their risk for developing aggressive disease
the benefits and harms of cancer screening compared to not screening

Most experts feel that the benefits outweigh the harms for people at high risk for aggressive cancer.

See below for expert guidelines.

What are the signs of cancer?

All people at high risk for cancer should be educated on the possible signs. However, cancer may not cause any symptoms, especially in its earliest stages. You should report any of the following symptoms to your doctor:

problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night
blood in the urine or semen

People with more advanced cancer may develop the following symptoms (note: these symptoms do not necessarily mean you have cancer; other conditions can cause the signs listed below):

trouble getting an erection
pain in the hips, back or other bones
weakness or numbness in the legs or feet
loss of bladder or bowel control
weight loss
fatigue

Prostate screening guidelines for high-risk people

The National Comprehensive Cancer Network (NCCN) has guidelines for cancer screening for people age 40 and older who are at increased risk.

Gene or Risk Level	Beginning Age	Recommendation
	40	Recommend Specific Antigen () test. Many experts also recommend a digital rectal examination that allows your doctor to feel for abnormalities in the .
	50 (or earlier based on the youngest case of cancer in the family)	Talk with your doctor about the benefits, costs and risks of having a baseline MRI. () is a special type of imaging that can create a more detailed map of the .
	40	Have a conversation with your doctor about your risk for aggressive cancer and the benefits and risks of screening. If you choose to have screening, the guidelines recommend a Specific Antigen () test. Many experts also recommend a digital rectal examination that allows your doctor to feel for abnormalities in the .
	50 (or earlier based on the youngest case of cancer in the family)	If you choose to have screening, talk with your doctor about the benefits, costs and risks of having a baseline MRI. () is a special type of imaging that can create a more detailed map of the .
	40	Have a conversation with your doctor about the potential benefits, risks, costs and limitations of screening for cancer. If you choose to have screening, the guidelines recommend a Specific Antigen () test. Many experts also recommend a digital rectal examination that allows your doctor to feel for abnormalities in the . Researchers are testing new approaches to cancer screening for high-risk people through clinical trials.
Black/African American People with a family history of cancer	40	Have a conversation with your doctor about the potential benefits, risks, costs and limitations of screening for cancer. If you choose to have screening, the guidelines recommend a Specific Antigen () test. Many experts also recommend a digital rectal examination that allows your doctor to feel for abnormalities in the . Researchers are testing new approaches to cancer screening for high-risk people through clinical trials.
Source: NCCN Guidelines: Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, , vs. 2, 2025; Source: NCCN Guidelines: Cancer Early Detection, vs. 1, 2026.

Prostate screening guidelines for average-risk people

There are several different guidelines for cancer screening in people of average risk. All of the guidelines include having a conversation with your doctor about your risk for cancer and the benefits, risks and limitations of screening using PSE testing and DRE. The recommended frequency of screening depends on whether the results are low or slightly elevated. See the table below for more details.

Guideline	Beginning Age	Recommendation
National Compre- hensive Cancer Network (NCCN)	45	Have a conversation with your doctor about the benefits and risks of screening. Consider screening with Specific Antigen () test and digital rectal exam (DRE). If you choose to have screening: For people whose DRE is normal and is low (<1 ng/ml) screening should be performed every 2-4 years. For people with slightly elevated of 1-3 ng/ml and normal DRE, screening should be repeated every 1-2 years. After age 75, screening every 1-3 years should be considered for healthy people.
The U.S. Preventive Services Task Force ()	55 until age 70	Have a conversation with your doctor about the benefits and risks of screening in order to decide what is right for you. The does not recommend cancer screening after age 70.
American Cancer Society	50	Have a conversation with your doctor about the benefits and risks of screening in order to decide what is right for you. If you choose to have screening: and DRE should be performed every 2 years as long as DRE is normal and is low (<2.5 ng/ml). and DRE should be performed every year if DRE is normal and is 2.5 ng/ml or higher.
Source: NCCN Guidelines: Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, , vs. 2, 2025; Source: NCCN Guidelines: Cancer Early Detection, vs. 1, 2026; American Cancer Society Recommendations for Cancer Early Detection.