Prostate Cancer Screening and Diagnosis

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      When it is found and diagnosed early, prostate cancer is curable. One of the best ways to detect it early is through screenings. Screenings check for a condition, like cancer, in people who don’t have any signs or symptoms. The two most common screening tests for prostate cancer are a prostate-specific antigen (PSA) test and a digital rectal exam (DRE).

      If your physician thinks you might have prostate cancer — based on your symptoms, DRE or PSA test — you may need further tests. This may include a biopsy. A biopsy involves taking a tissue sample for testing. A pathologist, a physician who specializes in checking tissue samples, uses a microscope to see if the cells are cancer. Fred Hutch Cancer Center pathologists are experts in diagnosing prostate cancers.

      Take Charge of Your Health

      Talk to your primary care provider if you have questions about prostate cancer screening and which tests may be right for you. UW Medicine Primary Care can help you get started. Learn about Fred Hutch's relationship with UW Medicine.

      Guidelines for Who Should Be Screened for Prostate Cancer

      Fred Hutch’s prostate cancer specialists recommend the following:

      • Men under 40: DRE and PSA screenings are not recommended for men at average risk.
      • Men 40 to 54: DRE and PSA screenings are not recommended for men at average risk.
      • Men 55 to 69: DRE, PSA or both screenings may be right for you. Talk with your physician about the risks and benefits.
      • Men 70 or older: DRE and PSA screenings are generally not recommended. But men who are in excellent health may benefit from screening.

      Talk with your primary care provider (PCP) about screenings if:

      • You have any questions about whether DRE or PSA is right for you
      • You are any age and have risk factors, such as a family history of certain cancers or inherited genetic mutations that may increase risk

      Together, you and your PCP can make a screening plan based on:

      • Your prostate cancer risk
      • Your overall health and life expectancy
      • Your desire for treatment if you are diagnosed with the disease

      Our care partner, UW Medicine, offers offer in-person and telemedicine primary care visits to both new and established patients. Learn about UW Medicine Primary Care. 

      Why Choose Fred Hutch for Prostate Cancer Screening and Diagnosis

      If you are thinking about coming to Fred Hutch for prostate cancer care, you’ve probably already been diagnosed by your primary care provider or a specialist, like a urologist. At Fred Hutch, our experts review your biopsy and other test results. In some cases, we may do further tests to make sure we have all the details we need to recommend the right treatment for you. In partnership with UW Medicine, we offer a full range of tests to diagnose and stage prostate cancer and plan individualized care.

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      Dr. Peter Nelson
      Dr. Peter Nelson is the Genitourinary Oncology Clinical Research director at Fred Hutch and holds the Stuart and Molly Sloan Precision Oncology Institute Endowed Chair.

      Prostate Cancer Screening and Diagnosis FAQ

      Good prostate cancer screening tests have led to early diagnosis in about 80% of men with the disease. According to the American Cancer Society, all of these men survive at least five years. Screening alone is credited for one-third of the recent decrease in prostate cancer deaths.

      Both DRE and PSA tests can detect signs that might be from prostate cancer. A PSA test is more accurate. But sometimes in a DRE, a physician can feel something abnormal that turns out to be cancer, even if a man’s PSA level is normal. Neither test can confirm the presence of cancer for certain. For this, you need a biopsy.

      Researchers are studying ways to make PSA tests more useful so physicians know if a patient with high PSA needs a biopsy and if a patient’s cancer is likely to be aggressive. They’re also developing ways to use urine tests to screen for prostate cancer and decide if a patient needs a biopsy. Other studies are looking at ways to combine information from imaging tests, like magnetic resonance imaging (MRI), with blood or urine tests to gauge a patient’s prostate cancer risk before they have a biopsy.

      If your DRE finds something abnormal or your PSA is high, talk with your physician to decide the best next step. Common options after a high PSA include:

      • Doing a DRE if you only had a PSA test or doing a PSA test if you only had a DRE.
      • Repeating a PSA test in one to two months to see if the level is still high. If it is, your physician might suggest doing repeat PSA tests and DREs to see if anything changes.
      • Having other blood tests, urine tests or imaging tests, like prostate-specific membrane antigen (PSMA) PET scan to detect prostate cancer cells outside the prostate.
      • Having a prostate biopsy to check for cancer cells.

      Learn more about the next steps after getting your PSA results.