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Prostate Cancer: Early Detection

Learn about the options for prostate cancer screening. Stay up to date by signing up for our community newsletter.

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Screening for Cancer

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:

Types of prostate screening

When an abnormality is found

Benefits and harms of screening

Signs of prostate cancer

How do you screen for prostate cancer?

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

Prostate Specific Antigen () 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 imaging.

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 tests.

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 and 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 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, 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, especially for people at high risk for aggressive cancer.

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):