Prostate Cancer Awareness Month: What Every Man Should Know About Screening
September is Prostate Cancer Awareness Month. If you've been meaning to have the screening conversation, this is a good moment. Here's the reassuring truth up front: prostate cancer is common, but most men who are diagnosed do not die from it — and when it's caught early, treatment is highly effective.
Quick Answers About Prostate Cancer Screening
Should I be screened for prostate cancer?
The urologists' own guideline (AUA, 2023) recommends offering regular PSA screening every 2 to 4 years from ages 50 to 69, with a baseline PSA at 45 to 50 — and starting at 40 to 45 for men at higher risk [4]. The American Cancer Society suggests starting the conversation at 50 (45 or 40 with risk factors) [2]. Either way, it's a short conversation with your doctor — covering both benefits and potential harms like false positives — not a mandate.
What does screening actually involve?
Usually just a PSA blood test, which the AUA recommends as the first screening test, sometimes combined with a prostate exam [4]. It's quick, and there's no special preparation.
Does an elevated PSA mean I have cancer?
No. An elevated PSA can come from many benign causes — an enlarged prostate, inflammation, or even recent activity. The AUA guideline specifically says a newly elevated PSA should be repeated before moving to any further testing, because PSA often normalizes on its own [4].
Is prostate cancer curable?
When found while still localized, the five-year survival rate is nearly 100%, according to the American Cancer Society [1]. More than 3.5 million American men who have been diagnosed are alive today [1][2].
What the guidelines say
Major medical organizations agree on the core message — screening should be a personal decision made with your doctor — but they frame the ages slightly differently:
- American Urological Association (2023): Recommends offering regular PSA screening every 2 to 4 years for men ages 50 to 69 [4]. A baseline PSA can be offered at 45 to 50, and screening should start at 40 to 45 for men at increased risk — including Black men, men with a strong family history, and those with certain gene mutations [4]. If a PSA comes back newly elevated, the guideline says to repeat the PSA before moving to any further testing [4].
- American Cancer Society: Recommends the screening conversation at 50 for average-risk men, 45 for high-risk men, and 40 for very-high-risk men [2].
- U.S. Preventive Services Task Force (2018): Recommends that men ages 55 to 69 make the decision individually with their clinician, and recommends against routine screening after 70 [3].
They're closely aligned on the essentials: it's your decision, made with your doctor, based on your personal risk — and that conversation should cover both the benefits and the potential harms of screening, such as false-positive results, overdiagnosis, and overtreatment [3][4]. One nuance worth noting: the AUA takes a slightly more directive stance, recommending that clinicians offer regular screening to men 50–69, while the USPSTF frames the 55–69 decision as strictly individual [3][4].
How common is it, really?
About 1 in 8 men will be diagnosed with prostate cancer in his lifetime, making it the most common non-skin cancer in American men [1]. The American Cancer Society estimates about 333,830 new cases in 2026 [1]. It is the second-leading cause of cancer death in men — yet the death rate has fallen by roughly half since the early 1990s, largely because of earlier detection and better treatment [1].
One trend worth knowing: diagnoses have been rising about 3% per year, with the steepest increase in advanced-stage cases [2]. The likely reason, according to the ACS, is that screening conversations are happening too late for too many men — especially those at higher risk [2]. Awareness month exists to fix exactly that.
What happens if something is found?
Finding something early is the best-case scenario, because it gives you the most options — including active surveillance (careful monitoring without immediate treatment), which is appropriate for many low-risk cases. Not every finding leads to surgery. An evaluation typically starts with a conversation, a repeat PSA [4], and sometimes an MRI before anyone discusses a biopsy.
Frequently Asked Questions
At what age should I start thinking about prostate cancer screening?
The AUA guideline says clinicians may offer a baseline PSA at 45 to 50, and should offer screening starting at 40 to 45 for men at increased risk [4]. The ACS suggests the conversation at 50 for average risk, earlier with risk factors [2].
What are the symptoms of prostate cancer?
Early prostate cancer usually causes no symptoms at all — which is precisely why screening matters. Later symptoms can include urinary changes, blood in urine or semen, or bone pain, but these can also come from benign conditions.
Should I still be screened after age 70?
Current guidance generally recommends against routine screening after 70, since the potential harms tend to outweigh the benefits at that point [3]. If you have concerns, it's still worth a conversation.
Does prostate cancer treatment always affect sexual function?
Not always, and it depends on the treatment. This is one of the most common worries men have, and it's a fair question to ask before any treatment decision. Some approaches, like active surveillance, have no direct effect at all.
I feel fine. Do I really need to think about this?
Feeling fine is exactly when screening is most useful. The goal is to find things before they cause symptoms, when options are simplest.
Sources
- American Cancer Society, Key Statistics for Prostate Cancer (2026 estimates, lifetime risk, survival data) — https://www.cancer.org/cancer/types/prostate-cancer/about/key-statistics.html
- American Cancer Society, Prostate Cancer Awareness Month 2026 announcement (screening guidance, 3% annual rise, "conversations happening too late") — https://pressroom.cancer.org/prostate-cancer-awareness-2026?asPDF=1
- U.S. Preventive Services Task Force, "Screening for Prostate Cancer: Recommendation Statement," JAMA 2018;319(18):1901–1913 (individual decision 55–69; against routine screening 70+; benefits and harms of screening)
- Wei JT et al., "Early Detection of Prostate Cancer: AUA/SUO Guideline Part I: Prostate Cancer Screening," J Urol 2023;210(1):46–53 — https://doi.org/10.1097/JU.0000000000003491
Dr. Mahyar Kashani, MD
Fellowship-trained urologist and Director of Male Sexual Health at Men's Health Long Island. Specializing in prostate health, low testosterone, erectile dysfunction, Peyronie's Disease, and advanced men's health care.
Take the first step
If you're due for the screening conversation — or if a past PSA result left you with questions — Dr. Kashani offers discreet consultations at two Long Island locations, in Rockville Centre and Carle Place.
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