Prostate Exam Age: When Do You Need One?

The prostate gland is essential for males.

It is essential to increase semen volume and facilitate the job of sperm cells.

It is located around the urethra, leaning against the rectum and below the urinary bladder.

Prostate problems are increasingly more common as we age.

They cause symptoms such as slow urinary stream, dribbling after urinating, increase in urinary frequency, urinary retention.

But when is the right time to start getting prostate exams?

When to get a prostate exam

Prostate screening is essential for most aging males.

For many years, all patients were recommended to get a prostate exam after a certain age.

Right now, the recommendations by the U.S. Preventive Services Task Force are slightly different. Prostate cancer screening should start after 55 years, but not all patients should get screened (2).

If you don’t have risk factors or symptoms, your age is not enough reason to screen.

Still, you can do it if you’re worried about your prostate.

Also, keep in mind that some average risk factors could be unknown to you. Thus, the best way to know if you need a prostate exam or not is by asking your urologist.

Men should decide for themselves if they prefer to perform an exam.

Still, health authorities recommend that males with a healthy prostate after 70 years do not perform additional exams (3).

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Types of prostate exams

The most common types of prostate exam include (4):

Prostate Specific Antigen

PSA screening is a blood test that measures a protein created in the prostate gland.

Digital rectal exam

A digital rectal exam (DRE) allows doctors to feel the prostate against the rectal wall.

It facilitates the detection of abnormalities in the gland.

Transrectal ultrasound of the prostate

This provides a clear image of the prostate, and it is not as expensive as a CT scan or an MRI.

Prostate biopsy

A prostate biopsy consists of taking a sample of the prostate.

It is analyzed in the lab to see if you have cancer cells.

Should you get a prostate exam?

Ideally, you should discuss the pros and cons of getting a prostate exam with your doctor.

Cancer screening has risks you need to understand before starting the process.

One of them is overdiagnosis and experiencing undesired side effects of prostate biopsies.

There are more risks than benefits in prostate exams for patients above 70 years.

That’s why they are often advised against screening.

After 55 years, patients with urinary symptoms should get screened.

Those with a family history of prostate cancer may also require screening (3).

How to prepare

Depending on the type of prostate exam, you may need preparation or not.

You should not have sex before a PSA test. You may need to use a cleansing enema before getting a transrectal ultrasound.

But no special preparation is often required before a digital rectal examination.

What to expect

In most cases, cancer screening only requires a simple blood test.

In such a case, it will be a standard blood test, and you want to inform the technician if you suffer from dizziness.

Digital rectal exams are very fast procedures.

You will need to remove your clothes and change into a gown. After that, you will be asked to lie on your side and adopt a fetal position.

Your doctor will use gloves and lubrication to insert one or two fingers into the rectum. The sensation can be uncomfortable but usually not painful.

The experience usually lasts no more than a few minutes.

Results

Waiting time for the results depends on the exam.

It takes longer to get the results of a prostate biopsy. But the PSA testing results are very fast, and digital rectal exams immediately give doctors a first impression.

After reading and comparing everything, your doctor could reach any of the following conclusions:

Normal results

You may not have any prostate ailment at the moment

Prostate enlargement

Enlarged prostate or benign prostatic hyperplasia (BPH) is very common as men age.

This ailment is not malignant and can be successfully treated.

Prostate cancer

You may require additional exams to diagnose prostate cancer.

Remember that an initial finding is not a definite diagnosis.

Prostatitis

Prostatitis is more common in younger adults and does not always give symptoms.

When it does, they are urinary tract symptoms similar to those found in BPH.

Deciding Your Next Steps

After getting your results, the doctor will tell you what to do next, depending on the findings.

Let’s take the PSA level as an example. You took a blood sample and got your results.

If a man’s PSA level is lower than 2.5 ng/ml, the doctor may recommend a new test in 2 years.

More regular prostate cancer screening would be recommended for an elevated PSA level higher than 2.5 ng/mL. It is usually once a year.

Additionally, your doctor will look through and compare your age with your PSA levels. If they are in the threshold level for your age, they may recommend new tests.

If the urologist has previous PSA readings, they will merge them to obtain PSA velocity.

This measure allows doctors to detect prostate cancer more accurately.

Conclusion

Early detection of prostate problems is essential.

Early prostate cancer treatment is usually successful and does not carry many complications.

But routine screening guidelines vary constantly depending on current statistics. 

But at what age should you start screening with a prostate exam?

There’s not an ideal prostate exam age. Instead, doctors recommend screening depending on risk factors.

Patients with an increased risk and those with urinary symptoms are the ones who need a PSA blood test, especially if they are over 55 years old.

But then, after 70 years, it is not recommended to perform a PSA screening test or any other.

An elevated PSA level should be compared with the baseline, any previous reading, and the patient’s age.

Thus, there isn’t a standardized measure to detect a prostate problem like prostate cancer.

Doctors would ask for further testing if there’s any suspicion and walk you through the diagnostic process.

Explore More

prostate health tips

How To Protect Your Prostate From BPH, Prostatitis, and Prostate Cancer.

Sources

  1. Heidenreich, A. P. J. B., Bastian, P. J., Bellmunt, J., Bolla, M., Joniau, S., Mason, M. D., … & Zattoni, F. (2012). Guidelines on prostate cancer. European association of urology, 45.
  2. Vane, S. (2019). Prostate Cancer Screening: A Review of Current Recommendations. Urologic Nursing, 39(3).
  3. Grossman, D. C., Curry, S. J., Owens, D. K., Bibbins-Domingo, K., Caughey, A. B., Davidson, K. W., … & US Preventive Services Task Force. (2018). Screening for prostate cancer: US Preventive Services Task Force recommendation statement. Jama, 319(18), 1901-1913. https://pubmed.ncbi.nlm.nih.gov/29801017/
  4. Catalona, W. J. (2018). Prostate cancer screening. Medical Clinics, 102(2), 199-214. https://pubmed.ncbi.nlm.nih.gov/29406053/

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