There are several National Guidelines for when men should get screened with PSA. All recommend that men make a shared decision with their doctor about whether to be tested for the presence of prostate cancer, based on age, life expectancy and general health status. The recommendation from the American Cancer Society :
Men “make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting information about the uncertainties, risks, and potential benefits of prostate cancer screening.”
Generally, screening should take place for:
Age 50 for men at average risk of prostate cancer and are expected to live at least 10 more years.
Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative (father, brother or son) diagnosed with prostate cancer at an early age (younger than age 65).
Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).
After these discussions have taken place, men who still want to be screened should get the PSA blood test. The digital rectal exam may also be used as a part of the screening.
If PSA is elevated, get a 4K Score (see Genetics tab) blood test to determine if you have aggressive cancer
If PSA is raised, and the 4K score is high, get a Multiparametric MRI. This will detect the location of cancer and direct where to biopsy
Consider Targeted Fusion Biopsy to reduce complications and improve the accuracy of the Biopsy.