How Often Should You Get a Prostate Exam?

Evidence Based Screening Guidelines Every Man Should Know

Prostate exams are an important part of men’s health, particularly as men age. One of the most common and often confusing questions is:
How often should you get a prostate exam?

Medical guidance has evolved over the past decade. Rather than recommending routine annual exams for all men, most medical organizations now emphasize personalized screening schedules based on age, risk factors, prostate-specific antigen (PSA) levels, and shared decision making with a healthcare provider.

This article explains:

• What a prostate exam includes

• How often men should be screened by age

• PSA testing vs. digital rectal exams

• Benefits and risks of prostate screening

• Current recommendations from leading medical organizations

What Is a Prostate Exam?

A “prostate exam” may refer to one or both of the following screening methods:

Digital Rectal Exam (DRE)

A physical exam in which a clinician inserts a gloved finger into the rectum to assess the size, shape, and texture of the prostate. While historically common, the DRE is no longer the primary screening tool for prostate cancer due to limited sensitivity when used alone. ¹

Prostate Specific Antigen (PSA) Blood Test

The PSA test measures levels of PSA, a protein produced by prostate tissue. Elevated PSA levels may be associated with prostate cancer, but they can also result from benign prostatic hyperplasia (BPH), prostatitis, or infection. PSA testing is now the main method used to guide prostate cancer screening decisions. ²

Why Prostate Screening Is Important and Complex

Prostate cancer is one of the most frequently diagnosed cancers among men in the United States. Early detection can be beneficial, but prostate screening is not without risks.³

Potential downsides include:

• False-positive PSA results

• Overdiagnosis of slow-growing cancers

• Anxiety and unnecessary biopsies

• Possible long term side effects from treatment, such as urinary incontinence or erectile dysfunction

Because of these tradeoffs, most organizations now recommend shared decision making rather than automatic screening. ⁴

At What Age Should Men Start Prostate Screening?

Men at Average Risk

• Most men should begin discussing prostate screening with a healthcare provider between ages 45 and 50.⁵

Men at Higher Risk

Men may be considered at higher risk if they:

• Have a first-degree relative with prostate cancer

• Are of African descent

• Have known genetic risk factors

Higher-risk men are often advised to begin discussions as early as ages 40–45. ⁶

How Often Should You Get a Prostate Exam by Age?

Ages 40–49

• Routine screening is generally not recommended for average risk men

• Higher-risk men may consider baseline PSA testing after discussion with a clinician

Ages 50–69

This is the age range where screening may offer the greatest benefit.

• PSA screening every 2–4 years is commonly recommended

• More frequent screening may be advised if PSA levels rise

• Annual screening is usually unnecessary for most men⁷

Age 70 and Older

• Routine prostate screening is generally not recommended

• Decisions may be individualized based on overall health and life expectancy⁴

What Do Major Medical Organizations Recommend?

United States Preventive Services Task Force (USPSTF)

• Men aged 55–69 should make an individual decision about screening

• Routine screening is not recommended for men 70 and older ⁴

American Urological Association (AUA)

• Supports PSA screening every 2–4 years for men aged 55–69

• Strongly emphasizes shared decision-making⁷

American Cancer Society (ACS)

• Men with PSA levels below 2.5 ng/mL may test every two years

• Men with higher PSA levels may benefit from annual testing⁵

Is the Digital Rectal Exam Still Necessary?

The digital rectal exam is now:

• Used less often as a routine screening tool

• Sometimes performed when PSA levels are abnormal

• Helpful in evaluating urinary symptoms or prostate abnormalities

PSA testing remains the primary screening method for most men. ¹

Benefits of Prostate Screening

• May detect prostate cancer before symptoms develop

• Allows for early monitoring or treatment when appropriate

• Helps guide long-term prostate health decisions

Risks and Limitations of Prostate Screening

Over diagnosis.

Some prostate cancers grow very slowly and may never cause symptoms, yet screening can still detect them.³

False Positives.

Elevated PSA levels do not always indicate cancer, which may lead to unnecessary follow-up testing.

Treatment Side Effects.

Prostate cancer treatments can result in urinary, bowel, or sexual side effects, which is why active surveillance is often considered for low-risk cases. ⁸

How to Decide What’s Right for You

The ideal screening schedule depends on:

• Age

• Family history

• PSA trends over time

• Overall health and life expectancy

• Personal values and comfort with risk

A healthcare provider can help tailor a screening plan based on these factors.

Quick Summary: How Often Should You Get a Prostate Exam?

• Ages 40–45 (high risk): Begin screening discussions

• Ages 50–69: PSA screening every 2–4 years for most men

• Elevated PSA: Screening may be more frequent

• Age 70+: Routine screening usually not recommended

Medical Disclaimer

This content is for informational and educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional regarding prostate screening, medical conditions, supplements, or treatment decisions. Screening recommendations may vary based on individual health factors.

References

1. Health.com. Digital Rectal Exam: What to Expect. 2024. Overview of the procedure, what men should expect, and its role in prostate screening.
2. Centers for Disease Control and Prevention (CDC). Prostate Cancer Screening. 2023. Evidence-based guidance on screening recommendations and early detection strategies.
3. National Cancer Institute (NCI). Prostate Cancer Screening (PDQ®). 2023. Comprehensive overview of PSA testing, digital exams, and clinical guidelines.
4. U.S. Preventive Services Task Force (USPSTF). Prostate Cancer: Screening Recommendation. 2022. Official recommendations for prostate cancer screening in adult men.
5. American Cancer Society (ACS). American Cancer Society Recommendations for Prostate Cancer Early Detection. 2023. Guidance on risk-based screening and patient counseling.
6. Johns Hopkins Medicine. Prostate Cancer Screening. 2024. Educational resource on the importance of screening, testing options, and follow-up.
7. American Urological Association (AUA). Early Detection of Prostate Cancer Guideline. 2023. Clinical practice guideline for screening, early detection, and risk stratification.
8. Memorial Sloan Kettering Cancer Center. Prostate Cancer Screening Guidelines. 2023. Summary of evidence-based recommendations for prostate cancer testing and follow-up care.