Prostate Cancer Screening: Making a Decision

Man in consultation with a healthcare provider.Should you be screened yearly for prostate cancer, even if you have no symptoms? Experts disagree. Below are some factors to think about as you make a decision.

Why prostate cancer screening is controversial

Not all healthcare providers agree that prostate cancer screening is useful. This is because:

  • PSA test results are not always right. In some cases, the PSA test can have false-positive or false-negative results. A false-positive means that test results show a man may have cancer when he doesn’t. This can lead to more tests, which can lead to stress and possible harm from the tests. A false-negative means that test results do not show cancer when a man does have cancer. This can mean you don't get the additional tests or the treatment you need.

  • Finding prostate cancer early may not be helpful.  Even if screening does help find cancer early, prostate cancer often grows slowly and most often affects older men. This means that finding it early may not lead to a longer life. Many men with prostate cancer die years later of other causes. They may never have symptoms or be treated for their cancer. But healthcare providers can’t always tell which cancers are likely to grow fast and need to be treated. Even if a cancer is slow-growing, a man may want it treated. Treatment for prostate cancer can have serious side effects. These include erection problems and lack of urine control.

Talking with your healthcare provider

Expert groups advise that men talk with their healthcare providers. This can help you make an informed decision about screening. Ask any questions you have about testing. Talk with your healthcare provider about:

  • Your personal risk for prostate cancer based on your age, race, and family history

  • What the screening test results can and can’t tell you

  • What the next steps would be if the test results show you might have prostate cancer

  • What your choices would be for treating or not treating right away

  • What the treatment choices are if you were to have treatment