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Prostate Cancer: Screening Guidelines

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Overview Prostate Cancer: Early Detection Prostate Cancer: Screening Guidelines

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Cancer Screening Guidelines

Note that when we use the terms "male" and "men" we are referring to people assigned male at birth. This section covers the following topics:

Guidelines for high-risk people

Guidelines for average-risk people

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cancer screening for high-risk people

The National Comprehensive Cancer Network (NCCN) has guidelines for screening using tests and digital rectal exam (DRE) in people age 40 and older who are at increased risk for cancer.

If you have a mutation, NCCN recommends yearly screening.
NCCN recommends other high-risk people should consider annual screening after having a conversation with their doctor about the benefits and risks of testing. This includes people who:
- have a mutation in another gene linked to cancer
- have a family history of cancer
- are Black/African American
High-risk people should consider enrolling in a screening clinical trial.

See the table below for more details.

Prostate screening guidelines for those at high risk: Table of guideline

Gene or Risk Level	Beginning Age	Recommendation
BRCA2	40	Recommend annual digital rectal exam and Prostate Specific Antigen (PSA) test.

ATM BRCA1 CHEK2 EPCAM HOXB13 MLH1 MSH2 MSH6 PALB2 PMS2 TP53	40	Have a conversation with your doctor about your risk for aggressive prostate cancer and the benefits and risks of screening. Consider digital rectal exam and PSA testing every 1-2 years depending on prior screening results.
Black/African American People with a family history of prostate cancer	40	Have a conversation with your doctor about your risk for aggressive prostate cancer and the benefits and risks of screening. Consider digital rectal exam and PSA testing every 1-2 years depending on prior screening results.
Source: NCCN Guidelines: Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, Prostate, vs. 2, 2025; Source: NCCN Guidelines: Prostate Cancer Early Detection, vs. 2, 2024.

Screening for average-risk people

There are several different guidelines for cancer screening in people of average risk. All of the guidelines include having a conversaton 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.

NCCN recommendations begin at age 45.
The U.S. Preventive Services Task Force () recommendations begin at age 55.
The American Cancer Society (ACS) recommendations begin at age 50.

Prostate cancer screening guidelines for those of average risk: Table of prostate cancer screening guidelines

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 Prostate Specific Antigen (PSA) test and digital rectal exam (DRE). If you choose to have screening: For people whose DRE is normal and PSA is low (<1 ng/ml) screening should be performed every 2-4 years. For people with slightly elevated PSA of 1-3 ng/ml and normal DRE, screening should be repeated every 1-2 years. After age 75, screening every 1-4 years should be considered for healthy people.
The U.S. Preventive Services Task Force (USPSTF)	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 USPSTF does not recommend prostate 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: PSA and DRE should be performed every 2 years as long as DRE is normal and PSA is low (<2.5 ng/ml). PSA and DRE should be performed every year if DRE is normal and PSA is 2.5 ng/ml or higher.
Source: NCCN Guidelines: Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, Prostate, vs. 2, 2025; Source: NCCN Guidelines: Prostate Cancer Early Detection, vs. 2, 2024; American Cancer Society Recommendations for Prostate Cancer Early Detection.

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