“Men over 50 need a PSA test.”
Men over 50 do not all need a PSA test; screening is a personal choice with a small benefit and real trade-offs.
Turning 50 does not mean you must get a PSA test. Screening is a reasonable choice for many men in their mid-50s to late 60s, especially those at higher risk, and skipping it is also reasonable after weighing the trade-offs.
Bring up PSA screening at your next checkup and decide with your doctor based on your age, risk and what matters to you.
Safety note: An elevated PSA does not by itself diagnose cancer. A low result cannot explain away concerning symptoms.
Talk to a healthcare professional if: you have urinary problems or other symptoms that worry you, or you want help deciding whether prostate cancer screening is right for you, especially if you are Black or have a close relative who had prostate cancer.
Large randomized trials show that PSA screening slightly lowers the chance of dying from prostate cancer in men aged about 55 to 69, but it also finds many cancers that would never have caused harm. Because the benefit is small and comes with trade-offs, guidelines treat screening as a personal choice rather than something every man over 50 needs, and that conclusion rests on strong trial evidence.
Men over 50 do not all need a PSA test; screening is a personal choice with a small benefit and real trade-offs. In a large European trial of men aged 55 to 69, inviting men to repeated screening prevented about 1 prostate cancer death for every 456 men invited over 23 years, while raising the number of cancers diagnosed by about 30%.
Screening can find slow-growing cancers that would never have caused illness, and follow-up biopsies and treatment can cause urinary, sexual and bowel problems. In a UK trial of men aged 50 to 69, a single screening invitation lowered prostate cancer deaths from 0.78% to 0.69% over 15 years and mainly found more low-grade cancers. The US Preventive Services Task Force calls screening an individual decision for men aged 55 to 69 and recommends against it at 70 and older; an update of that recommendation is in progress.
Who might benefit from PSA screening to reduce prostate cancer deaths?
Men aged about 55 to 69 who expect to live many more years gain the most, and the US task force says family history and race should be part of the decision because Black men and men with a family history have higher risk. In the European trial, screening prevented about 2 prostate cancer deaths per 1,000 men invited over 23 years.
- Roobol MJ, de Vos II, Månsson M, Godtman RA, Talala KM, et al.; ERSPC Investigators. European Study of Prostate Cancer Screening: 23-year follow-up. New England Journal of Medicine. 2025;393(17):1669-1680. DOI: 10.1056/NEJMoa2503223. PMID: 41160819
- Martin RM, Turner EL, Young GJ, et al.; CAP Trial Group. Prostate-specific antigen screening and 15-year prostate cancer mortality: a secondary analysis of the CAP randomized clinical trial. JAMA. 2024;331(17):1460-1470. DOI: 10.1001/jama.2024.4011. PMID: 38581198. PMCID: PMC10999004
- US Preventive Services Task Force. Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(18):1901-1913. DOI: 10.1001/jama.2018.3710. PMID: 29801017
- National Cancer Institute. Prostate-Specific Antigen (PSA) Test. Accessed 6 October 2026