What Is Prostate Cancer Screening?

By Rodney Herbert
The PSA blood test measures a protein made by the prostate and is a key screening tool for prostate cancer. Prostate cancer screening means looking for signs of prostate cancer before you have symptoms. The two main tests used to screen for prostate cancer are the PSA blood test and the digital rectal exam (DRE) cinj.org. These tests can help find prostate cancer early, when it is easier to treat.

  • PSA Blood Test: This test checks a sample of your blood for a substance called PSA (prostate-specific antigen). PSA is a protein made by the prostate. It’s normal for men to have a low level of PSA in their blood. But if the level is higher than usual, it could be a sign of a prostate problem. A high PSA level does not always mean cancer, but it tells the doctor that more checking might be needed​. The PSA test is simple – just a quick blood draw from your arm.

  • Digital Rectal Exam (DRE): This is a physical exam of the prostate. The doctor puts on a glove, adds some gel, and gently inserts a finger into the rectum (back passage) to feel the prostate. This lets the doctor check if the prostate is enlarged or has any hard or lumpy areas​. It might sound uncomfortable, but it is very quick. Many men find the DRE a bit embarrassing, but it usually isn’t painful and only takes a minute​ prostatecanceruk.org

Screening tests like PSA and DRE are important because they can catch prostate cancer early. Finding the cancer early means finding it before it spreads or causes problems. When prostate cancer is found early, there are more treatment options and a better chance of a cure. If you wait until you feel symptoms, the cancer might be harder to treat. That’s why doctors encourage men to get screened at the right time, especially men who have higher risks.

Why Screening Matters More for Black Men

Prostate cancer can affect any man, but it does not affect all men equally. Black men (for example, African American men) have a higher risk of getting prostate cancer than men of other races​ uclahealth.org. They are also more likely to get it at a younger age and to have more serious cases. In fact, studies show that prostate cancer often develops several years earlier in Black men compared to others​ pubmed.ncbi.nlm.nih.gov. This means a Black man could get prostate cancer in his late 40s or early 50s, while another man might not get it until his 60s.

Black men are not only more likely to develop prostate cancer, but they are also more likely to die from it if it’s not caught early​. Doctors and health experts have noticed this worrying trend. Scientists are still studying why this happens. But one thing is clear: early and regular screening can make a big difference. By checking for prostate cancer sooner and more often, doctors hope to find any cancer in Black men as early as possible​ mskcc.org. Early detection could help save lives by treating the cancer before it grows or spreads.

“Overall, Black men may need earlier and more frequent screening than the general guidelines would suggest”​ mskcc.org. This means that the usual advice for when to start screening might not be enough for Black men. Because of the higher risk, Black men should be proactive. Screening is a form of protection. It’s like checking the smoke alarm regularly in a house where the risk of fire is higher. If you know you have a higher chance of a problem, you take action sooner. For Black men, screening early is taking action to protect their health.

When Should Black Men Start Screening?

So, when is the right time to begin checking for prostate cancer? For most men at average risk, doctors often suggest starting screening around age 50​. At that age, the chance of prostate cancer starts to increase. However, Black men have a higher than average risk. Experts recommend that Black men start prostate cancer screening earlier than age 50​. Many medical guidelines say that men at high risk – including Black men – should talk to their doctor and consider starting screening at age 45​. Starting a few years earlier gives a better chance to catch any cancer early. In fact, some newer expert panels suggest getting a baseline PSA test sometime between age 40 and 45 for Black men​ pubmed.ncbi.nlm.nih.gov. A “baseline” test means your first test, which gives a starting point for your PSA level. If that first test at 40–45 is normal, your doctor will know your baseline PSA number to compare with future tests.

If you have other risk factors on top of being Black, you might need to start even sooner. For example, if your father or brother had prostate cancer, especially if they got it at a relatively young age, that raises your risk too. In that case, some doctors suggest you consider beginning screening as early as age 40​. Remember, these ages (40 or 45) are earlier than what is recommended for men at normal risk. The goal is to give high-risk men a head start in finding any cancer.

It’s best to talk with a doctor by the time you are about 40–45 if you are a Black man. Together, you can make a plan for screening. Don’t wait until you are older to bring it up. If you are in your early or mid-40s and haven’t discussed prostate health with a doctor yet, now is a good time. Even if you feel perfectly healthy, having that first conversation and test can give you peace of mind.

How Often Should You Get Screened?

Screening isn’t a one-time thing – it’s something you do regularly. But how often should these tests be done? The answer can depend on your risk and your last test results. For Black men at higher risk, many doctors recommend getting the PSA blood test every year or at least every other year​ pubmed.ncbi.nlm.nih.gov. Frequent testing can catch any changes in PSA levels from year to year. If your PSA starts to rise, even a little, your doctor can notice it quickly and do further checks.

If your first screening tests are completely normal, your doctor might say you can come back in two years for the next test. Some guidelines for average-risk men suggest a PSA test every two years instead of every year. However, because Black men have a higher chance of getting prostate cancer, a yearly check is often advised to be on the safe side​. Checking every year means less time for a potential cancer to grow unnoticed.

Let’s put it simply:

  • Average-risk men: often get a PSA test every two years or so, starting later in life.

  • Higher-risk men (like Black men): should consider a PSA test every year, starting earlier.

The digital rectal exam (DRE) might be done on a similar schedule. Some doctors do a DRE every year along with the PSA test. Others might do it less often, especially if the PSA is low. You can ask your doctor what they recommend in your case. But doing both tests regularly gives the best chance to catch anything unusual.

Another thing to keep in mind is how long to continue screening. Men do not need to screen forever. Usually, if a man reaches about 70 years old and has been screening regularly, he might stop screening at that point​. This is because prostate cancer often grows slowly, and at an older age, other health issues might be more of a concern. If you are a Black man over 70 and you’ve had typical screening results, talk with your doctor about whether you should keep going or if it’s okay to stop​. But if you are still in good health, some doctors might continue to check PSA for a bit longer. It really depends on your overall health and personal wishes.

Tips for Knowing When You Need More Frequent Checks

Every person is different. Some Black men might need to be especially careful and get checked more often. Here are some tips to help you know if you might need extra attention with screening:

  • Family History of Prostate Cancer: If your father, brother, or son had prostate cancer, you should be extra cautious. This is even more important if they were diagnosed at a younger age. A strong family history plus being Black puts you at very high risk. In this case, yearly screening from around age 40 is often recommended​.

  • Higher PSA Level in the Past: If you’ve had a PSA test before and the level was a bit high (even if it wasn’t high enough to diagnose cancer), your doctor might suggest checking more often. For example, if your PSA was elevated but a follow-up exam or scan didn’t find cancer, you might need to repeat the PSA test sooner (like in 6 months or 1 year) to watch it closely. A rising PSA over time can be an early warning sign, so it requires closer monitoring.

  • Abnormal Exam Results: If a doctor ever feels something unusual during a digital rectal exam – such as a bump or firm area on the prostate – you will need more tests. The doctor might order more advanced tests or imaging. Even if those tests don’t find cancer, you’ll likely need to have screening exams more frequently to make sure nothing was missed. Don’t panic if this happens; it is a precaution to keep you safe.

  • New Symptoms Appear: Remember, screening is for men who feel fine. But if you ever notice problems such as difficulty urinating, a weak urine stream, blood in your urine, pain in your lower back or hips, or any other worrying symptoms, see a doctor right away. These symptoms could be from advanced prostate cancer or from other prostate issues. You should not wait for your next scheduled screening if something like this comes up. Getting checked immediately is important.

  • If You’ve Never Been Screened and You’re Past 45: Some men may not have known about early screening and might be behind schedule. If you are a Black man older than 45 and have never had a PSA test or DRE, it’s time to start now. It’s okay if you’re late – it’s better to begin now than not at all. The moment you realize you might need a prostate check, call your doctor and set up an appointment.

By paying attention to these factors, you and your doctor can adjust how often you get tested. The key is to stay alert and proactive. Prostate cancer usually grows slowly, but in some cases it can grow faster. That’s why staying on top of it with regular check-ups is a smart idea when you have higher risk.

Don’t Be Afraid to Talk About It

Talking about prostate exams or cancer can feel uncomfortable for some men. It’s normal to feel a bit embarrassed or nervous, especially about the DRE exam. But remember that doctors do these exams all the time – it is a routine part of their job. For a doctor, a prostate exam is quick and important, and they want you to feel at ease. If you are worried, let your doctor know. They can explain the process and help you feel more comfortable.

Think of the PSA blood test and DRE as tools to keep you healthy, just like checking your blood pressure or getting a cholesterol test. There is nothing shameful about wanting to take care of your health. In fact, it shows strength and responsibility. If you have a spouse, partner, or friend, you can also talk to them about it. They can support and encourage you. Sometimes, wives or daughters help remind the men in their family to get screened, because they care about their health.

Also, don’t hesitate to ask questions. You can ask the doctor things like:

  • “When do you think I should start my prostate checks, given my background?”

  • “How often should I come in for a PSA test?”

  • “What does it mean if my PSA number is a little high?”

  • “What can I expect during the exam?”

Doctors appreciate when patients are involved and curious. It helps them guide you better.

Finally, if the idea of the DRE is what’s holding you back, keep this in mind: for a few seconds of discomfort, you get something that could save your life​. Many men who have gone through it say it’s worth it for the peace of mind. The slight embarrassment or discomfort passes quickly, but the knowledge you gain from screening is empowering.

Take Charge of Your Prostate Health

Prostate cancer is a serious health issue, but you have the power to take steps against it. If you are a Black man, knowing that you are at higher risk gives you a chance to be one step ahead. By starting screening early (in your 40s) and doing it regularly, you’re being proactive about your health. You’re not waiting for a problem to happen; you’re checking for it so you can catch it early.

Early and frequent screening has one main purpose: to find prostate cancer early when it can be treated and cured. It’s much better to find a problem when it’s small than to find it after it has become big. Think of it like fixing a small leak in your roof before it becomes a big hole. Regular check-ups are like maintenance for your body.

In summary, Black men should not wait until 50 or 55 to start thinking about prostate cancer screening. Start earlier, around 40 to 45, and get screened more often than the average man​ pubmed.ncbi.nlm.nih.gov. This could mean annual PSA tests and regular doctor visits. These simple steps could make a life-saving difference. Prostate cancer screening is a key part of staying healthy for men at higher risk. By staying informed and proactive, you are taking control of your health and doing your best to stay cancer-free.