What age should I get a prostate exam?

October 15, 2019

Prostate health is one of the most important concerns for men as they age. Prostate cancer awareness is a mainstream concern and more and more men are feeling comfortable discussing prostate health with their doctors. Still, there’s some confusion about when to get a prostate exam or if it’s advisable to get a prostate exam. Dr. Koushik Shaw of Austin Urology Institute is a prostate expert and regularly helps men navigate this situation.

Prostate cancer is the second-leading cause of cancer deaths among men in the United States. Yet, when detected in its early stages, prostate cancer can be effectively treated and cured. Routine screening helps in detection of prostate cancer, and involves a blood test and an exam. Recently there has been some debate on how often to screen, at what age, and if to screen at all. The American Urological Association (AUA) has updated the guidelines for prostate cancer screening and addressed some of these topics.

When should I be screened for prostate cancer?

The easiest thing you can do to detect prostate cancer and catch it early, is be diligent about getting screened. Screening involves a blood test called a PSA, and prostate exam (also known as a digital rectal exam).  This can be done by your primary care physician or a urologist. The following guidelines are per AUA recommendations:

  • Age 55-70, who are low risk, get screened every 1-2 years.
  • Men under the age of 55 with no risk factors do not need to be screened
  • For men younger than age 55 years at higher risk (e.g. positive family history or African American race), decisions regarding prostate cancer screening should be individualized
  • Over the age of 70 can continued to be screened if life expectancy is greater than 10 years.

If your doctor feels that a screening test was suspicious, he may check your PSA more frequently until it is stable.

Why is there a debate about screening?

There is questioning among healthcare professionals regarding the over-diagnosis and overtreatment of prostate cancer. However, screening to see if cancer is present is still important. If the doctor suspects cancer, then he may decide to proceed with a prostate biopsy. We recognize that not all patients need to be treated if they have prostate cancer. For example, an elderly patient (age 80+) with a small amount of prostate cancer may not necessarily be affected by the cancer due to its slow growing nature. In certain patient populations, treatment may lead to more harm than good. Each patient has a different story, and while we recommend routine screening, further diagnosis and treatment is at the doctor’s discretion based on each individual case.