When Men Need to Start Prostate Cancer Screening 

Dr. James Grant

| 3 min read

James D. Grant, M.D. is senior vice president and ch...

A man speaks with a female doctor during an appointment.
The American Cancer Society estimates that there will be about 268,490 new cases of prostate cancer diagnosed in the United States this year. Prostate cancer is the second most common cancer diagnosed in men, second only to skin cancer. Regular prostate exams may help men catch the disease early and receive appropriate treatment as soon as possible. 

When should men start to have prostate cancer screenings? 

Before undergoing a prostate screening test or prostate exam, men should talk with their primary care physician for an individualized recommendation. It is also important to understand the risks, benefits and potential uncertainties that may arise with screening results. 
On average, men should begin receiving yearly prostate exams at age 50 as part of an annual physical. However, some men may benefit from receiving the screening at age 40 or 45, depending on their risk factors, such as a family history of prostate cancer. 
The American Cancer Society provides the following guidelines for when to start screenings: 
  • Men with an average risk of prostate cancer and who are in generally good health can start at age 50.
  • Men who have a higher risk of developing prostate cancer can start at age 45. This includes African Americans and men who have a first-degree relative – father, brother or son – diagnosed with prostate cancer at an early age (younger than age 65).
  • Men who have an extremely high risk, including those with more than one first-degree relative who were diagnosed with prostate cancer at an early age, can start screening at age 40.

What is involved in a prostate cancer screening? 

Prostate cancer screenings include a prostate-specific antigen (PSA) blood test, which measures for a protein produced by the prostate gland. Sometimes, a physician also will conduct a digital rectal exam (DRE). 
  • The PSA blood test: Several factors can influence PSA levels found in a blood test. Evidence-based guidelines are updated frequently and help to identify those who are the best candidates for a blood screening. Men should talk with their physician about PSA results and appropriate course of action. 
  • The digital rectal exam: While the idea of a DRE is daunting to many men, it is actually very simple, quick and results in little to no discomfort. This exam can help physicians feel for irregularities or hard areas that could indicate cancer. 
While DRE and PSA exams are effective in evaluating the potential risk of prostate cancer, it is important to note that a biopsy is the only way to determine a definitive diagnosis. 

What are the symptoms of prostate cancer? 

In the early stages of prostate cancer, men often have no symptoms. This is why it is so important to be screened. When men do exhibit symptoms, they can include problems urinating, frequent urination, blood in urine or semen, or frequent pain or stiffness in the lower back, hips, or upper thighs. 

Can prostate cancer be prevented? 

There is no sure way to prevent prostate cancer, but there are ways to reduce a person’s risk. Leading a healthy lifestyle, limiting alcohol consumption, not smoking, maintaining a healthy weight and consulting regularly with a physician are good strategies. 
James D. Grant, M.D., is senior vice president and chief medical officer at Blue Cross Blue Shield of Michigan.
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