Why Older Men Should Still Get a PSA Check Every Year
By Dr. David Samadi
As men grow older, routine health screenings become more critical than ever—especially when it comes to prostate health. Yet many older men mistakenly believe they can skip their annual PSA (prostate-specific antigen) test, either because they feel fine or assume that prostate cancer isn’t likely to be serious. The reality is different.
Prostate Cancer Doesn’t Always Show Symptoms
One of the biggest challenges of prostate cancer is that it often develops without any noticeable symptoms. That means a man may feel perfectly healthy while cancer is quietly progressing. By the time symptoms like difficulty urinating, pelvic discomfort, or blood in the urine appear, the disease could be at a more advanced stage—potentially more complex to treat.
Early detection through a simple PSA blood test can make all the difference. When caught early, prostate cancer is often highly treatable, and survival rates are significantly better.
The Risk Increases with Age
Prostate cancer is a very common cancer among men, particularly those over the age of 65. The majority of prostate cancer cases are found and diagnosed in older men, with the average age of first diagnosis being 67. According to data from the American Cancer Society, it is estimated that 313,780 new cases of prostate cancer will be found in 2025, and more than 35,770 men will die from this disease also in 2025. While many prostate cancers in older men are often slow-growing, some can be aggressive and life-threatening if left undetected, like in the case of former President Joe Biden.
Without treatment, prostate cancer can take five to seven years from the time of diagnosis to spread to the lymph nodes or bones. However, the power of early intervention cannot be overstated. Surgically removing the prostate is often considered the most effective way to prevent the cancer from spreading beyond the gland. Once the prostate is removed and the cancer is contained, many men can be considered essentially cured. However, if the cancer spreads beyond the prostate, it is no longer considered curable. Early intervention is key, empowering you to take control of your health.
For men whose prostate cancer has metastasized to the bone, many medical advances have been made for men with advanced prostate cancer. At this point, the best treatment for men in President Joe Biden’s situation is hormonal treatment. Surgery or radiation are no longer an option when the Gleason score is at an 8, 9 or 10 and stage 4 cancer. Hormone therapy, also known as androgen deprivation therapy (ADT) will reduce the amount of testosterone (which can fuel cancer growth) helping slow the progression of the disease, providing more time for these men, but it will not cure the disease. Unfortunately, ADT treatment also can come with many side effect that may include erectile dysfunction, low libido, hot flashes, fatigue, bone thinning, cardiac issues and changes in mood.
This is why staying on top of routine PSA testing is still a smart move—even later in life.
But Don’t Some Guidelines Say to Stop Testing After 70?
Some organizations indeed advise against routine PSA screening in men over 70. I disagree with this advice. As long as a man has an intact prostate gland, whether he is 40 years old or 80, it is still in their best interest to encourage PSA testing on an annual basis. Let’s not forget that, prostate cancer has been the second-leading cause of cancer death among American men, behind only lung cancer, for many years.
Over the course of a man’s lifetime, 1 in 44 men will succumb to this disease. It’s important for men to know that the number of prostate cancer cases dropped significantly between 2007 and 2014, mainly because fewer men were getting screened due to changes in screening guidelines, like advising men not to get a routine PSA screening after age 70. Due to this advice, unfortunately since 2014, prostate cancer rates have been rising again—by about 3% each year.
However, getting an annual PSA test is still a personal decision every man 40 and older must make, in conjunction with their primary care physician or urologist. Discuss with them essential factors such as your overall health, any family history of prostate cancer, and your ethnicity – African American men and Caribbean men of African ancestry have a higher risk than in men of other races. I would advise any man with these risk factors to strongly consider having an annual PSA screening.
A Personalized Approach Is Best
Each man’s situation is unique. Family history, race, overall health, and past PSA levels all play a role in determining whether continued screening is appropriate. As discussed previously, men with a family history of prostate cancer or African American men or Caribbean men of African ancestry, face a higher risk and may benefit from ongoing screening, even into their 70s or beyond. But, I still give this same advice to men, even without these risk factors. Prostate cancer can develop quietly for years without causing symptoms—and by the time it shows up, it may already be serious. That’s why staying on top of annual PSA testing, even after age 70, can make all the difference in catching it early when it’s most treatable.
The best step? Have a conversation with your healthcare provider. Together, you can weigh the potential benefits and risks of continued PSA testing based on your individual health profile and personal preferences.
Don’t Let Discomfort—or Myths—Get in the Way
Some men avoid screenings because of fear or misunderstanding. The PSA test is a blood draw easily done in a doctor’s office. If a digital rectal exam (DRE) is also recommended, it’s quick, usually painless, and can provide important information about the health of the prostate. It’s normal to feel a little uneasy about these procedures, but remember, the peace of mind and potential life-saving benefits far outweigh any temporary discomfort.
It’s normal to feel a little uneasy about these procedures—but the peace of mind and potential life-saving benefits far outweigh any temporary discomfort.
The Bottom Line
Even if you’re feeling fine and have no symptoms, prostate cancer could still be developing silently. Annual PSA testing remains a valuable tool in catching the disease early—when it’s most treatable. If you’re an older man in good health, don’t assume you’ve aged out of prostate cancer screening.
Your health is worth protecting. Schedule a conversation with your doctor about whether continued PSA testing is right for you. Staying proactive now can preserve your well-being for years to come.
Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, Prostate Cancer, Now What? A Practical Guide to Diagnosis, Treatment, and Recovery, and The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.