When Should I Get Checked? A Simple Prostate Screening Timeline

You know you should get checked. You've heard about prostate cancer, maybe seen the stats, maybe even lost someone close to it. But when exactly are you supposed to start screening? And what does "screening" even mean?

Let's break it down in the simplest way possible — no medical jargon, no confusion. Just the facts you need to protect your health.

What Is Prostate Screening?

Prostate screening uses two main tools to check for cancer before you have any symptoms:

PSA Blood Test (Prostate-Specific Antigen)
This is a simple blood draw that measures the level of PSA in your bloodstream. PSA is a protein produced by the prostate, and higher levels can sometimes indicate cancer — though they can also point to non-cancerous conditions like an enlarged prostate or infection. The test gives your doctor a baseline to watch over time.

DRE (Digital Rectal Exam)
Yes, this is the exam everyone jokes about avoiding. A doctor inserts a gloved, lubricated finger into the rectum to feel the prostate for any lumps, hard areas, or unusual size. It takes less than a minute and, combined with the PSA test, provides a more complete picture of your prostate health.

Together, these tools help catch cancer early — often before it causes any symptoms at all. And catching it early is when survival rates are highest.

Your Age-Based Screening Timeline

Here's when to start the conversation, get tested, and keep monitoring based on your risk level:

If You're Black or Have a Family History of Prostate Cancer (High Risk)

Age 40–45: Start the Conversation
Schedule a visit with your doctor to discuss baseline PSA testing. If your father or brother was diagnosed with prostate cancer before age 65, or if you're a Black man, you fall into the high-risk category. Don't wait — this is your time to get ahead of it.

After Your First Test: Annual Screening
High-risk individuals often need yearly PSA tests, at least until age 70–75 (depending on your overall health and life expectancy). Your doctor will adjust the frequency based on your results and any changes over time.

If You're at Average Risk (No Family History, Not Black)

Age 50–55: Start the Conversation
Talk to your doctor about whether PSA screening makes sense for you. The decision should be based on weighing the benefits (early detection) against potential harms (false positives, overdiagnosis).

After Your First Test: Every 1–2 Years
If your PSA is low (under 1.0 ng/mL), you might only need retesting every 5 years. Higher levels will prompt more frequent checks or additional exams.

Age 55–69: Individualized Decisions

This is the age range where screening is most commonly recommended for average-risk men. Work with your doctor to decide what's right for you based on your health, values, and preferences.

Age 70 and Beyond: Talk to Your Doctor

Routine screening typically isn't recommended after age 70, unless you're in excellent health with a life expectancy of 10+ years. The reason? At this point, the risks of overdiagnosis and unnecessary treatment often outweigh the benefits. But every situation is different — have the conversation with your healthcare provider.

What to Ask at Your Doctor's Visit

Going into your appointment prepared makes a huge difference. Here are the key questions to ask:

"Given my age and that I'm a Black man, when do you recommend I start PSA testing?"
This puts your specific risk factors front and center. If you're not Black but have a family history, adjust the question accordingly: "My father/brother was diagnosed with prostate cancer at age ___. When should I start screening?"

"Does my family history mean I should see a urologist or consider genetic counseling?"
If multiple relatives have had prostate cancer, or if someone in your family was diagnosed young, you might benefit from seeing a specialist or exploring genetic testing for inherited mutations like BRCA2.

"If my PSA is slightly elevated, what are the next steps? Can we repeat the test before doing a biopsy?"
PSA levels can fluctuate due to infection, recent sexual activity, or other benign causes. A single elevated result doesn't always mean cancer. Asking about repeat testing can help avoid unnecessary procedures.

"How often should I get screened based on my first results?"
Frequency matters. Make sure you understand whether you'll need annual tests, every couple of years, or less often.

"What PSA level would concern you, and what would we do then?"
Understanding the benchmarks helps you know what to expect and removes the anxiety of waiting for results without context.

How Often Should You Get Retested?

After your first screening, frequency depends on your results and risk level:

• Low PSA (under 1.0 ng/mL): Retesting every 5 years may be sufficient
• Normal to slightly elevated PSA: Every 1–2 years is typical
• High-risk individuals (Black men, family history): Often annual screening until at least age 70–75
• Elevated or rising PSA levels: More frequent monitoring or additional tests will be recommended

Your doctor will create a personalized schedule based on your unique situation.

The Bottom Line

Prostate screening isn't one-size-fits-all. Your age, race, and family history all shape when you should start and how often you should get checked. But one thing is universal: having the conversation early is better than waiting until symptoms appear.

If you're a Black man or have a family history of prostate cancer, your screening timeline starts in your early 40s — not your 50s. That decade matters. It could be the difference between catching cancer early, when it's almost always beatable, and catching it late, when treatment becomes much harder.

The Question You Need to Answer

Do you know what screening plan makes sense for your age and family history?

If you don't, that's okay — but it means it's time to schedule that doctor's visit. Write down your questions, mention any relatives who've had prostate cancer, and make sure you walk out with a clear plan.

Your health is too important to leave to chance. Get checked. Know your baseline. Follow through.

Because catching prostate cancer early isn't just possible — it's powerful.

For more information, visit the American Cancer Society's screening guidelines and ZERO Prostate Cancer.