PSA testing frequency depends on your age, risk factors, and prior results. Here are common recommendations you can discuss with a clinician:
- General guidance
- If you are at average risk and have no symptoms, many guidelines suggest starting discussions around age 50, with PSA testing considered every 1–4 years depending on your initial results and shared decision making. For some men, especially older adults with limited life expectancy, screening may be less frequent or not recommended. These ranges appear in multiple reputable sources and reflect a balance between potential benefits and harms of PSA screening.
- Higher-risk groups
- Men with higher risk (e.g., family history of prostate cancer, African ancestry, or certain genetic factors) are often advised to begin screening earlier (around age 45) and may undergo testing more frequently (annually or every 1–2 years) depending on individual PSA trends and doctor’s assessment.
- Prior PSA results
- If prior PSA values have been low and stable, your clinician may extend the interval (e.g., every 2–4 years). If results are rising or fall into a borderline range, more frequent testing (every 1–2 years) may be recommended.
- Practical considerations
- PSA testing is just one piece of the assessment. A doctor may also consider age, overall health, urinary symptoms, physical examination (including a digital rectal exam depending on guidelines), and patient preferences when determining screening frequency.
What to prepare for your discussion
- Your age and general health
- Family history of prostate cancer
- Any urinary symptoms or changes
- Previous PSA results (if any), including the value and the date
- Your values and preferences regarding potential follow-up tests or biopsies if PSA is elevated
If you’d like, I can tailor these guidelines to your age and risk factors. Tell me your age, race/ethnicity (if you know it), and whether you have any family history of prostate cancer. I’ll summarize a personalized screening plan and questions to discuss with your clinician.
