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Do I Need a PSA Test for Prostate Cancer?

November 12, 2025

Prostate cancer is one of the most common cancers in American men — and it often grows quietly.

“Prostate cancer typically doesn’t cause symptoms until it’s already advanced,” says Andrew Chang, MD, a urologist with the Hartford HealthCare Tallwood Urology & Kidney Institute. “That’s why screening can make such a difference.”

One of the most common screening tools is the PSA test – a simple blood test that measures prostate-specific antigen, a protein made by the prostate.

“An elevated PSA doesn’t automatically mean cancer,” says Dr. Chang. “But it tells us that we should take a closer look.”

So, do you need a PSA test?

It depends on your age, your risk factors and what matters most to you.

“This isn’t a one-size-fits-all screening,” explains Dr. Chang. “It’s a shared decision between you and your doctor. Together, you can weigh the risks and benefits based on your personal history and preferences.”

Here’s how Dr. Chang breaks it down:

• Younger men at higher-risk (ages 40–45): If you have a family history of prostate cancer, are Black, or carry BRCA1 or BRCA2 gene mutations, screening should start earlier. “We usually recommend starting screening earlier – around age 40 to 45,” says Dr. Chang.
• Most men (ages 50–69): This is the group where screening decisions are most individualized. “Talk with your doctor about the pros and cons and decide what’s right for you,” he says.
• Older adults (over 70): Routine PSA testing is usually not advised. “The benefits tend to be limited,” says Dr. Chang. “But for some men, we may recommend screening up to age 75.”

> Related: Should I Get Genetic Testing for Prostate Cancer? 

A high PSA doesn’t always mean cancer

PSA levels can rise for many reasons – including an enlarged prostate, infection, recent ejaculation or even cycling.

“A high PSA can cause a lot of worry and lead to more tests,” says Dr. Chang. “But most elevated results are not caused by cancer.”

Still, PSA testing remains the most effective tool for early detection of prostate cancer.

“It’s not a perfect test,” Dr. Chang adds. “There’s a risk of false positives and over diagnosis of low-risk, non-aggressive prostate cancer that we often do not actively treat nowadays. But early detection gives us more options and better outcomes for those who have more aggressive types of prostate cancer. It provides an opportunity to treat and cure before it’s too late.”

Talk to your doctor

The PSA test isn’t for everyone. But it could be right for you.

“If you’re between 50 and 69, or have risk factors, talk to your provider,” says Dr. Chang. “The best screening plan is the one that fits your health, your values and your future.”