Prostate Cancer Screening Options

Types of screening

Screening for 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.
• Clinical trials are looking at prostate screening using MRI imaging. 

Benefits and harms of screening

There are benefits and potential harms associated with prostate cancer screening.

• Most prostate cancers can be very slow growing and unlikely to spread or cause harm. Detecting and treating these slow-growing prostate cancers early may not improve health outcomes and side effects from biopsy or treatment may cause harm.
• 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 certain genes, including BRCA1 and BRCA2
  • people with a family history of young-onset or aggressive prostate cancer.

Other factors that affect the benefits and risks of prostate cancer include:

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

Several expert groups have guidelines for prostate cancer screening and each is slightly different. Most experts agree that people should have a discussion with their doctor about prostate cancer screening, that 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

Many experts feel that the benefits outweigh the harms, especially for people at high risk for aggressive cancer. 

When an abnormality is found

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