When should men be tested for prostate cancer?

Prostate cancer screening is highly controversial. Most physician groups recommend men discuss with their physician the pros and cons of prostate cancer screening and make a decision they are comfortable with. This discussion should be had around the age of 50. If you have a family history of prostate cancer there are stronger arguments for screening.

Prostate cancer screening has not proven to improve overall survival in men and can lead to invasive and expensive procedures that may otherwise be avoided. Conversely, screening may lead to a cancer being found that may spread. 

Prostate cancer is usually a slow growing cancer that remains in the prostate. When prostate cancer is found, we are unable to tell if it will remain in the prostate or spread. 

Also, the available screening tests for prostate cancer are not very specific or sensitive. PSA testing is difficult as cancer may be present at any level and high PSAs may be found in benign enlarging prostates. Digital prostate exams have poor sensitivity and variable physician interpretation. 

If you decide to screen, the best method is probably a digital rectal exam and PSA blood test yearly starting at age 50. Possibly sooner if you have a strong family history.