Understanding Prostate Cancer Screening: What You Need to Know 

Prostate cancer is one of the most common cancers among men in the United States. While it often has no symptoms in its early stages or grows slowly, early detection can improve care or treatment options and outcomes. That’s why understanding when and how to get screened is important, especially as men get older.

Make an informed decision about your prostate health

“Prostate cancer screening can detect cancers that are aggressive and warrant treatment, but screening can also detect prostate cancers that are slow-growing, not invasive and are better managed by monitoring, also called ‘surveillance’, instead of immediate treatment,” says Martin Sanda, MD, a urologist at Winship Cancer Institute of Emory University.

“That’s why it’s important to weigh the pros and cons of screening with your doctor. Your age, family history, race, overall health and personal values all play a role in making the best decision for you.”

The decision to get screened for prostate cancer is not one-size-fits-all. Both the U.S. Preventive Services Task Force and the American Cancer Society recommend that men talk with their health care provider to make an informed choice based on individual risk factors and preferences.

If you are over 40 and have a family history of prostate cancer, are African American—a group with notably higher incidence in the U.S.—or have another health condition that increases your risk, speak to your doctor about the risks and benefits of being screened.

Signs and symptoms of prostate cancer may include:

• Frequent need to urinate or difficulty urinating
• Pain during urination
• Blood in the urine
• Erectile dysfunction without a known cause (like high blood pressure, cardiovascular disease, neurological disorder or diabetes)
• Pain in the lower back, pelvis, hips or upper thighs not relieved by over-the-counter medicines

These symptoms can be caused by other conditions and are not always related to prostate cancer. If you experience any of them, talk with your doctor.

PSA testing to screen for prostate cancer is generally not recommended for men with a life expectancy of less than 10-15 years unless they have symptoms that could be due to an advanced prostate cancer, such as pelvic pain, bone pain or difficulty urinating.

The decision to undergo PSA-based screening should be made individually. If you choose to be screened, you may only need testing every two to three years if your PSA level is under 3.0 ng/mL. If it’s higher, attention by your primary care provider is recommended, and the possibility of seeing a urologist should be considered. Discuss the potential benefits and harms with your doctor. Together, you can create a screening plan tailored to your needs. 

Some men face a higher risk of developing prostate cancer. African American men and Caribbean men of African ancestry are more likely to be diagnosed and to develop aggressive forms of the disease. Men with a family history—especially an immediate relative such as a father or brother diagnosed at a young age—are also at increased risk.

Inherited genetic mutations, such as BRCA1 or BRCA2, and conditions like Lynch syndrome can further elevate risk.

Informed decision-making matters

Men between the ages of 55 to 70 should discuss pros and cons of possible prostate cancer screening with a care provider. Men between 40 to 55 years of age who have risk factors such as a family history of prostate cancer, or who are of African-American racial background — should speak with their doctor about prostate cancer screening. An informed conversation today could help you make the right choice for your future health.

"The PSA test is a valuable tool for prostate cancer screening, but it's not perfect," says Dr. Sanda. "Understanding the potential benefits and limitations of PSA testing, along with discussing the best approach with a healthcare professional, is essential for making informed decisions about what to do if you have an abnormal PSA test result."

At Emory Healthcare, our primary care physicians are prepared to speak with you about prostate cancer screening and connect you with our urology and genitourinary oncology experts in the case of a prostate cancer diagnosis. Call us at 404-778-7777 to request an appointment with a primary care physician. 

Winship Cancer Institute of Emory University, with generous support from the Arthur M. Blank Family Foundation and in partnership with Mount Sinai in New York City, is bringing mobile prostate cancer screening directly to communities across Georgia. This program is designed to increase early detection and help reduce longstanding disparities in prostate cancer by providing free screenings in the community by experienced clinical staff.

Learn more about mobile prostate cancer screening at emoryhealthcare.org/prostatebus.

Prostate cancer care at Winship Cancer Institute 

The prostate cancer care team at Winship Cancer Institute of Emory University is highly experienced in detecting, monitoring and treating prostate cancer. The team includes urologists, medical oncologists, radiation oncologists, pathologists, nuclear medicine specialists, advanced practice nurses and others, all working together for you.  

They are committed to providing accurate diagnoses, guiding patients in making informed decisions about their care options, delivering high-quality treatment and ensuring follow-up after care. 

Winship’s prostate cancer program offers innovative treatment options to patients across the Southeast, including access to the Emory Proton Therapy Center, the only proton beam treatment facility in Georgia.

Learn more about prostate cancer care at Winship.