Empowering Veterans with knowledge for prostate health decisions

At VA, we strive to make sure you are well-informed. That way, you can take charge of your health. You can also make confident decisions about your care.

VA offers many preventive health services, including screening for cancers. Screening for prostate cancer is done with a blood test that measures the amount of prostate-specific antigen (PSA) protein in the blood. An elevated PSA level may be caused by prostate cancer. It can also be caused by other conditions, too, including an enlarged prostate and inflammation of the prostate.

VA recommends talking with your health care provider. Screening for prostate cancer with PSA testing may not be the right choice for all Veterans but, together, you can decide whether it is the right choice for you.

What do I need to know to make a decision about prostate cancer screening?

To determine if prostate cancer screening is right for you, you and your health care provider will consider three key questions:

1. How do I know if I am at increased risk for prostate cancer?
2. What are the potential benefits and potential harms of prostate cancer screening?
3. How might my values and preferences impact my decision to be screened for prostate cancer?

How do I know if I am at increased risk for prostate cancer?

Certain men may be at increased risk of developing prostate cancer, such as:

• Men with a family history of prostate cancer.
• Men that have been exposed to Agent Orange or other toxins.
• Black male Veterans.
• Men with a known variant in their genes.

VA recommends that men aged 55-69 talk with their health care provider about their individual risk of developing prostate cancer before deciding whether or not to get screened. Men outside of this age group can also talk to their provider if they have questions about prostate cancer screening.

VA does not recommend routine prostate cancer screening for average-risk men over 70. This is because evidence shows that the potential harms of screening for prostate cancer outweigh the potential benefits in this age group. 

What are the potential benefits and potential harms of prostate cancer screening?

Screening offers a small, potential benefit of reducing the chance of death from prostate cancer in some men. This benefit is small because many prostate cancers discovered during screening are slow-growing and have limited impact on health. However, many men will experience harms of screening. These may include:

• Test results that require further testing and possible prostate biopsy (using a needle to take a sample of tissue from the prostate to determine whether cancer is present).
• A “false positive” test (a result that, upon further testing, turns out to be something other than cancer).
• “Overtreatment” (finding and treating a very slow growing cancer that is less likely to produce significant health problems).
• Potential complications of prostate cancer treatments, such as incontinence (difficulty in holding urine) or erectile dysfunction (difficulty getting an erection when engaging in sexual activity).

How might my values and preferences impact my decision to be screened for prostate cancer?

VA recommends that you talk with your provider about your values and preferences regarding screening. For example, how important is it that you know that you have prostate cancer? Some men have a strong preference to make sure they don’t have a hidden cancer. Others don’t share this view, especially because many prostate cancers are slow growing and don’t lead to serious complications.

We also encourage you to share your thoughts and feelings about the potential harms of subsequent treatments if prostate cancer is found. For example, some men feel more strongly than others about wanting to avoid potential impacts of prostate cancer treatments on their urinary and sexual function.

What steps can I take to make a decision about prostate cancer screening?

VA recommends that you talk with your provider about your risks for prostate cancer, the potential benefits and potential harms of screening, and your personal preferences and values related to PSA screening. Together, you can determine if screening is right for you.

For more information

To learn more about prostate cancer, visit VA’s National Oncology Program website. You can also find a helpful infographic about whether prostate cancer screening is right for you, and an interactive Decision Aid Tool for prostate cancer screening in the Veterans Health Library.