Screening means checking for a health problem before you have symptoms. This can sometimes help find diseases, like certain cancers, early. This can lead to early treatment. Finding and treating cancer early, when it's small and hasn't spread, may improve the chance that treatment will work better.

But it's not clear yet whether screening for prostate cancer is helpful. Learning more about prostate cancer screening and the risks and benefits of it can help you decide if it's right for you.

Two screening tests can be used to check for prostate cancer.

• PSA blood test. This test looks at the level of prostate-specific antigen (PSA) in your blood. PSA is a protein made by prostate cells. A high level means it's more likely that you have prostate cancer. This test can be done alone or with a digital rectal exam.
• Digital rectal exam (DRE). In this exam, the doctor puts a lubricated, gloved finger into your rectum to check the size of your prostate and feel the surface of it through the bowel wall. The doctor will check for any hard lumps or abnormal areas. Only part of the prostate surface can be felt during the exam. A DRE is best performed with a PSA blood test.

Abnormal results on these screening tests can mean that you might have prostate cancer, but these tests can't diagnose prostate cancer. A prostate biopsy is needed to be sure. During a biopsy, tiny pieces of tissue are taken out of the prostate and tested in a lab.

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

• PSA test results aren't always right. In some cases, the PSA test can have false-positive or false-negative results. A false positive means that the test results show that you may have cancer when you don't. This can lead to more tests, which can lead to stress and possible harm from the tests. A false negative means that the test results don't show cancer when you have it. This can mean you don't get the extra tests or 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 mostly affects older adults. This means that finding it early may not lead to a longer life. Many people with prostate cancer die years later of other causes without having symptoms or being treated for their prostate cancer. But doctors can't always tell which cancers are likely to grow fast and need to be treated. And even if a cancer is slow-growing, some people may not want to live with the cancer. They may want to treat it. And treatments for prostate cancer can have serious side effects, such as erection problems and lack of urine control (incontinence).

It's not yet clear if the benefits of screening for prostate cancer are greater than the possible harms. Research studies have found that prostate cancer screening can find more cancers. But it's still not clear if screening saves enough lives to outweigh the harm that treatments can cause.

Researchers are looking for better ways to know:

• Which prostate cancers need to be treated early.
• Which prostate cancers can be safely watched over time.
• The ideal ages to start and stop screening.
• How often to test (ideal frequency).
• How best to screen people who are at high risk.

At this time there are no standard tests that give this kind of information.

Most expert medical groups agree that routine prostate cancer screening should not be done for all men. But the advice varies between groups. For example:

• U.S. Preventive Services Task Force says that people ages 55 to 69 should talk with their doctor about the possible benefits and harms of screening so they can make an informed decision.
• American Urological Association says that people should talk with their doctor about the pros and cons of screening. They suggest that people ages 50 to 69 who are at average risk for prostate cancer should be given the choice to have prostate cancer screening. They suggest that people may begin screening as young as ages 45 to 50. Those at higher risk could have this choice earlier.
• National Comprehensive Cancer Network says that people should talk with their doctor about the pros and cons of screening starting at age 45. Those at high risk should have this talk at age 40.
• American Society of Clinical Oncology says that people who are expected to live at least 10 years or more should talk with their doctor about whether screening is right for them.
• American Cancer Society says that people should talk with their doctor about the pros and cons of screening. They advise having this talk at age 50 for those at average risk who are expected to live for 10 years or more. People who have African ancestry or who have a father or brother (first-degree relative) who was diagnosed with prostate cancer before age 65 are at high risk. They should have this talk at age 45. The society advises people to discuss screening at age 40 if they are at even higher risk. This means having more than one first-degree relative who was diagnosed before age 65.

All the medical expert groups advise that people talk with their doctor to make an informed decision about screening. If you're thinking about being screened, talk with your doctor about:

• Your personal risk of prostate cancer based on your age, ancestry, 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 that you might have prostate cancer.
• What your choices would be for treating or not treating the cancer right away.
• What the treatment choices would be if you wanted to have treatment, including the benefits and possible harms of different treatments.