Risk factors

The exact cause of prostate cancer is unknown. Prostate cancer risk is influenced by several factors. Having one or more risk factors does not mean you will develop prostate cancer. It simply means you may benefit from a more personalized plan for early detection with your healthcare provider.

Age: Risk increases with age, especially after age 50.

Race: Black or African American men are more likely to be diagnosed with prostate cancer and more likely to die from the disease.

Family history: Risk is higher if a close relative has had prostate cancer. A family history of breast, ovarian, colorectal, pancreatic, or endometrial cancer can also increase risk, especially when cancers occur at younger ages.

Inherited genetic mutations: Inherited mutations such as BRCA1, BRCA2, HOXB13, ATM, and other genes can increase the risk of prostate cancer in some families. Genetic risk can also affect how screening is approached.

Occupational and chemical exposures: Some exposures may be associated with higher risk. This can include veterans with Agent Orange exposure and certain occupations with repeated chemical or carcinogen exposure, including firefighters, first responders, pilots, and agricultural workers.

Symptoms

Many men have no symptoms in the early stages of prostate cancer. That is one reason early detection can be important. Urinary symptoms are common in men as they age and are often caused by benign prostate enlargement, not cancer. Still, new or worsening symptoms should be discussed with a healthcare provider.

Symptoms that may occur

• No symptoms, especially early on
• Frequent urination, especially at night
• Weak urinary stream
• Trouble starting urination or fully emptying the bladder
• Stopping and starting during urination
• Pain or burning during urination
• Blood in the urine or ejaculate
• Persistent bone pain, such as hips, ribs, or back
• Unexplained weight loss or fatigue

Screening and early detection

Early detection is a shared decision between a man and his healthcare provider. Screening does not diagnose prostate cancer. It helps estimate risk and determine whether follow up is needed.

Early detection commonly uses a prostate specific antigen, PSA, blood test. A digital rectal exam, DRE, is optional and is often used when PSA is elevated, when symptoms are present, or when a clinician feels it is appropriate.

View PCEC screening guidance PDF

PSA blood test

PSA is a protein made by the prostate. PSA is prostate specific, but it is not cancer specific. PSA can rise from many causes, including benign prostate enlargement, inflammation, infection, recent ejaculation, recent cycling, or recent procedures. PSA results should be interpreted in context, and trends over time often matter more than a single number.

Baseline PSA at age 45

PCEC recommends that men obtain a baseline PSA blood test at age 45. This baseline helps guide how often future testing may be needed.

PCEC PSA monitoring guidance

PSA less than 1.5 ng per mL
Most men are considered lower risk. Repeat PSA every 2 to 4 years, unless additional risk factors suggest closer follow up.

PSA 1.5 ng per mL or higher
This does not mean cancer. It may indicate a prostate health condition or a higher risk level. Repeat PSA and discuss next steps with a healthcare provider.

Higher risk groups

Some men may benefit from earlier or more frequent discussions about screening and follow up. This can include men who are Black or African American, men with a strong family history of related cancers, men with known inherited genetic mutations, and men with certain occupational exposures.

What happens if PSA is elevated

An elevated PSA does not automatically mean a biopsy is needed right away. A clinician may recommend a repeat PSA, additional blood or urine testing, imaging such as prostate MRI, and in some cases genomic or biomarker tests to better estimate risk and decide whether biopsy is appropriate.

Additional PSA related tests

• Percent free PSA
• PSA density
• PSA velocity
• PSA doubling time
• Prostate Health Index, PHI

When screening may not be helpful

PCEC does not recommend early detection in men who have significantly decreased life expectancy due to other serious health issues and have no signs of prostate cancer or other prostate conditions. This is a discussion to have with your healthcare provider.

Digital rectal exam, DRE

A DRE is a quick exam in which a clinician feels part of the prostate through the rectum to check for firmness, lumps, or other changes. The entire prostate cannot be felt during a DRE, but it can provide useful information in selected situations.

Prevention and healthy lifestyle

No lifestyle change can guarantee prevention of prostate cancer. However, healthy habits may help reduce risk and support overall health.

• Maintain a healthy weight through nutrition and regular physical activity
• Limit red and processed meats and choose lean proteins more often
• Emphasize fruits, vegetables, whole grains, and healthy fats
• Discuss calcium intake with your clinician and avoid unnecessary high dose supplements
• Do not smoke and limit alcohol if you drink
• Use supplements cautiously and avoid doses above recommended daily allowances unless advised by a clinician

Prostate Conditions Education Council, together with our Screening Site Partners and countless volunteers who participate in prostate cancer screening events during Prostate Cancer Awareness Week, the entire month of September and year round events, has helped to screen over 5 million men since 1989!

Benefits of being a Screening Site Partner

You will be participating with one of the oldest and most successfully coordinated cancer screenings.

Community Outreach/Support Services
PCEC supports community outreach and education programs.  We can provide your organization with useful resources and the most update educational materials.

Marketing Support
Utilize our media kit for professional tools to help spread the word about your screening or awareness event.  Registered screening site partners also receive a FREE listing on this website and our toll-free phone locator service!

Low-Cost PSA Processing
Utilize our central laboratory for low-cost PSA processing and other blood testing as well!  Sites can customize their events to include other men’s health issues, such as; Testosterone, Cholesterol, HDL/LDL, Triglycerides and Glucose.  Blood processing starts at $9.00 per sample for PSA only!

Screening Supplies for FREE
You can receive many of your screening supplies for free, including screening questionnaire forms, PSA lab kits, media materials for local PR, etc.

Research
Working with PCEC is an excellent way for your organization to participate in state-of-the-art research.  Our program can also provide you with the tools to recruit and participate in research on your own!  Every year PCEC has had abstracts from our research accepted to major medical meetings across the country.

Final Data Reports
PCEC will provide to our Longitudinal and Tracking Screening Site Partners with an individual and national statistical site report at the conclusion of PCAW each year.

Levels of Participation and Site Requirements

There are many levels of participation that a site can choose; from returning a report that requires just a few minutes of your time, to more involved levels where you complete additional information used for state-of-the-art research, national studies and national reports. The level of participation is always the site’s choice and can vary from year to year. All of the site categories are an integral part of PCAW as our most important goal is to provide free or low-cost screenings to as many men as possible.

Participation Levels

Health Fair Site:  PCEC will support your event with educational materials, a listing on our website and have access to our media/tool kit.   

Basic Screening Site:  PCEC will support your event with educational materials, a listing on our website, toll-free phone locator and medial kit.  The site is required to submit to PCEC the simple Final Report Form indicating the number of hours and some demographic information about the men screened as well as the number of abnormal DRE’s and PSA’s is returned to PCEC at the end of your screening.

Tracking Screening Site*: PCEC will support your event with educational materials, a listing on our website, toll-free phone locator, medial kit as well as supply you with a detailed Screening Questionnaire with Consent Forms for your participants. Tracking Sites are required to send back to PCEC the completed original Screening Questionnaires with PSA results along with the simple Final Report Form indicating the number of hours and some demographic information about the men screened as well as the number of abnormal DRE’s and PSA’s is returned to the PCEC at the end of your screening.

Longitudinal Study Screening Site*: PCEC will support your event with low-cost PSA and other blood processing as well, supply you with a detailed Screening Questionnaire with consent form, PSA Lab Kits which include blood collection tubes, aliquot tubes and a box to store samples for shipping, educational materials, a listing on our website, toll-free phone locator and medial kit.  Longitudinal Study Sites are required to spin down the blood and pipette transfer into the aliquot tubes, frozen serum packed in the provided box on dry ice and overnight shipped to our central laboratory.  PCEC does not cover the cost of the shipping of the samples to the lab.  PCEC also requires the completed original Screening Questionnaires along with the simple Final Report Form indicating the number of hours and some demographic information about the men screened as well as the number of abnormal DRE’s and PSA’s is returned to the PCEC at the end of your screening.   PCEC emails the site coordinators with the blood test results soon after your event.

_{* Sites that return their PCAW screening questionnaire forms and PSA results to the Prostate Cancer Education Council are eligible to receive many screening supplies for FREE!}