Don's Home Health Cause of Death Cancer Prostrate PSA Screening
last updated 21 April 2026
There are 2 types of screening: digital rectal exam (DRE) and PSA (prostate specific antigen) blood testing. 
PSA 
level  probability
g/ml   of cancer
4-10     25%
> 10     50%
My test results in 2026 said < 6.5 is normal
Source: Guide to Prostate Diseases, Harvard, 2026-27
See Factors that can affect results.

When to get tested:
Routine PSA screening was frequently not recommended for men aged 70 and older because the potential for false-positives resulting in biopsies which can have complications which outweigh the benefits for men with limited life expectancy.

I was screened at age 80 and had a PSA of 69. (normal is < 6.5 ng/ml ) A biopsy gave me a Gleason score of 9 out of 10 (high). In this case the screening may have been a life saver.

The 2026 guidlines from the American Urological Association (se below) say "Clinicians may personalize the re-screening interval based on patient preference, age, PSA, prostate cancer risk, life expectancy, and general health following shared decision-making (SDM)"
At age 80 I was screened and had a PSA of 69. (normal is < 6.5 ng/ml ) A biopsy gave me a Gleason score of 9 out of 10 (high). Luckily it had not spread outside the pelvis region.
I asked my doctor why he ordered a PSA test. His response was,
"Regarding the test, every organization that creates guidelines on this has a different age they recommend stopping prostate cancer screening but it is really based on longevity. If the patient is doing fairly well, with a possible likelihood of living another 10 years or more, I tend to check one more time at age 80.
UCDAVIS HEALTH does not have a guideline for testing after age 75."

I was in good health, still skiing and playing tennis with no symptoms.

My PSA history: < 6.5 is normal
9/1977 (age 33) PSA <4.0 ng/mL <2.5 w/ saw pimento
2000 (age 56) PSA via instrumental differential 1.1 (good 0-4.6) Note says PSA with differential methods or reagents cannot be used interchangeably.

I couldn't find any PSA tests after age 60; I was concentrating on cholesterol; My father had bypass and my Mother had high cholesterol.

I was mainly following cholesterol after age 60 and couldn't find any PSA tests in my records.
Factors which can affect PSA results:
Any prostate stimulation can trigger the release of extra PSA. This can include ejaculation and vigorous exercise, especially bike riding - but even having a DRE (Digital Rectal Exam) can raise PSA levels.
References:
I did a literature search on when to get PSA tests and found the following:

The
Routine PSA screening was frequently not recommended for men aged 70 and older because the potential harms, including false-positive results and complications from subsequent biopsies, often outweigh the benefits for men with limited life expectancy.

More guidelines

1. Should I Get Screened for Prostate Cancer? | CDC Feb, 2025

Summary:
Other organizations, like the American Urological Association and the American Cancer Society, may have other recommendations.

Talk to your doctor:
The goal of screening for prostate cancer is to find cancers that may be at high risk for spreading if not treated, and to find them early before they spread. However, most prostate cancers grow slowly or not at all.

If you are thinking about being screened, you and your doctor should consider:

You are at increased risk for getting or dying from prostate cancer if you are African American.

See the complete article for:

Possible benefits of screening

Possible harms

Possible harm from screening

Possible harms from diagnosis
Screening finds prostate cancer in some men who would never have had symptoms from their cancer in their lifetime. Treatment of men who would not have had symptoms or died from prostate cancer can cause them to have complications from treatment, but not benefit from treatment. This is called overdiagnosis.

Possible harms from treatment

Video

2. Prostate Cancer: Age-Specific Screening Guidelines | Johns Hopkins 3/5/2026
Summary:
Age 40-54
You may need PSA screening if: Age 55-69
This is the age range where men will benefit the most from screening. That's because this is the time when:
Men are most likely to get cancer Most men will get prostate cancer if they live long enough. Some prostate cancers are more aggressive; others can be slow-growing. Doctors will take your age and other factors into consideration before weighing the risks and benefits of treatment.sss You should ask your doctor how often he or she recommends you get screened. For most men, every two to three years is enough. Depending on the results of your first PSA test, your doctor may recommend you get screened less (or more) frequently.sss

3. Interpreting PSA Levels at Age 75: Ranges, Guidelines, and Trade-offs | Consumer Search 3/22/26

They do not list any academic reference for these guidelines.
Summary:

At 75, other health problems often shape whether a PSA result matters.
A fit 75-year-old with many expected years ahead may reasonably consider further assessment for an elevated value.
Age group Common upper reference (ng/mL) Examples of evaluation thresholds
Age group Common upper reference (ng/mL) Examples of evaluation thresholds
50-59 around 3.5 3-4 often considered for further testing
60-69 around 4.5 4-6 depending on risk factors
70-79 around 6.5 values above 6 may prompt individualized evaluation

As a statistician in a previous life I'd like to see more data i.e. a multivariate data tumor size (Gleason score), PSA level, testosterone, age, ...
This may not be practical because prudence might call for surgery before Gleasson to too high.

There are several PubMed (NIH) articles with more data.