Whether to have periodic PSA blood testing to screen for prostate cancer.
Men aged 55 to 69 without a prostate cancer diagnosis. The Task Force recommends against PSA-based screening at 70 and older.
What this decision concerns
Many men with prostate cancer never develop symptoms and would not know they had it without screening; in other men the cancer is more aggressive and can lead to death. Screening aims to identify high-risk localized cancer before advanced or metastatic disease develops.
The Task Force states the decision should be an individual one, made after discussing benefits and harms with a clinician, and that clinicians should not screen men who do not express a preference for screening.
Source-backed process context, not a personal next-step recommendation.
PSA screening measures the amount of prostate-specific antigen protein in blood. An elevated PSA can be caused by prostate cancer, but also by benign prostate enlargement or prostatitis, so an elevated result is not a cancer diagnosis.
After an elevated PSA, diagnostic evaluation may include a transrectal ultrasound-guided core-needle biopsy. The screening result itself does not establish prostate cancer.
The 2018 Task Force statement does not set one fixed interval after a non-elevated PSA. Trials used intervals from 2 to 7 years, and the statement notes that screening every 2 or 4 years instead of annually may reduce overdiagnosis with only a small reduction in mortality benefit. The screening decision can be revisited over time.
A blood test repeated at intervals, with follow-up testing and possible biopsy if a result is abnormal.
Screening programs may prevent about 1.3 deaths from prostate cancer over about 13 years per 1000 men screened.
Applies to: Men aged 55 to 69 in randomized screening trials.
Screening programs may prevent about 3 cases of metastatic prostate cancer per 1000 men screened.
Applies to: Men aged 55 to 69 in randomized screening trials.
Harms include frequent false-positive results that require additional testing and possible prostate biopsy.
Applies to: Men screened with PSA testing.
Harms include psychological harm, overdiagnosis, and overtreatment.
Applies to: Men screened with PSA testing.
About 1 in 5 men who undergo radical prostatectomy develop long-term urinary incontinence.
Applies to: Men who go on to have radical prostatectomy, not all men screened.
About 2 in 3 men who undergo radical prostatectomy experience long-term erectile dysfunction.
Applies to: Men who go on to have radical prostatectomy, not all men screened.
No PSA test now. You can pick it up again at a later visit.
Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men. Not screening forgoes it.
Applies to: Men aged 55 to 69.
The harms the Task Force attributes to screening are false-positive results requiring further testing and possible biopsy, overdiagnosis, overtreatment, and treatment complications. Not screening avoids them.
Applies to: Men aged 55 to 69.
Many men with prostate cancer never experience symptoms and, without screening, would never know they have the disease.
Applies to: Men with prostate cancer in the US.
Read from what you saved on this device.
Nothing yet. Mark what matters to you, and anything the sources say about it shows up here.
Nothing so far pulls against anything else.
Nothing is marked as a priority yet, so nothing here is connected to what matters to you. The options and their sources are still readable below.
Not in the sources here.
How each man weighs the specific benefits and harms determines whether the overall net benefit is small for him.
US Preventive Services Task Force, 2018 statement
African American men and men with a family history of prostate cancer have an increased risk of prostate cancer compared with other men.
US Preventive Services Task Force, 2018 statement
What the evidence review found for those higher-risk groups is not carried in this record. Read the statement itself, or ask a clinician.
Not in the sources here.
This record carries the 2018 statement's own summary. It does not carry test intervals, what a particular practice offers, or cost and coverage.
Not in the sources here.
Sets source-backed statements about named options against what the person said matters. Does not meet the development and evaluation standard a patient decision aid requires. Three further stages would be needed to call it a patient decision aid: essential-criteria appraisal, an independent bias appraisal, and an evaluation of what it changes for the people who use it. None has been done. 3 criteria below are not fully met.
MetHealth conditionchecked automatically
A source-backed description of the health condition or event is recorded separately from the option comparison.
MetExplicit decisionchecked automatically
States the decision: "Whether to have periodic PSA blood testing to screen for prostate cancer."
MetTarget audiencechecked automatically
Names who this is for: "Men aged 55 to 69 without a prostate cancer diagnosis. The Task Force recommends against PSA-based screening at 70 and older."
MetOptionschecked automatically
2 options, including an explicit wait-or-decline option.
MetBenefitschecked automatically
4 recorded statements read as supporting an option.
MetHarmschecked automatically
5 recorded statements read as burdening an option.
MetValues clarificationrecorded judgment
Each statement is filed under a value dimension. The page sets those against priorities the reader saved on their own device. The reader states the priority. Nothing infers it.
Not metBest available evidencechecked automatically
2 primary sources cited, each paraphrased closely. Something that may supersede this source was found. A person has to decide. A person has to act on this before the row can pass.
Not metUser involvement in developmentrecorded judgment
No patient, caregiver, or clinician took part in developing this journey. No usability or comprehension testing has been run on it.
MetNeutral presentation of optionschecked automatically
Every option carries at least one statement in each direction, so no option is recorded as all upside or all downside.
MetComplete citationschecked automatically
2 sources, each with a full citation, a resolving identifier, a publication date, and the date and route it was read.
MetPublication or version datechecked automatically
Last reviewed 2026-09-18.
Not metUpdate policyrecorded judgment
Each journey records when it was last reviewed. A recheck cadence and triggers are proposed, and source recheck due dates are computed from them, but no owner has adopted the policy. This stays unmet until one does.
MetFunding disclosedrecorded judgment
Funding and editorial independence are stated at /independence.
MetWhat the test measureschecked automatically
The journey carries a source-backed explanation of what the screening test measures and the limits of interpreting a result.
MetConsequences of a positive resultrecorded judgment
Records false positives, further testing, biopsy, overdiagnosis, and overtreatment. Gives the incontinence and erectile-dysfunction rates that follow prostatectomy, each scoped to the men the source studied.
MetNext steps after either resultchecked automatically
The journey separately records source-backed follow-up context after an abnormal finding and after a non-abnormal result.
MetOverdiagnosis and false positivesrecorded judgment
Overdiagnosis and overtreatment are named as harms in the source's own terms. False positives are recorded separately.
This checks the seven IPDAS 5.0 qualifying criteria, seven bias-reduction criteria, and four screening-specific criteria against what each journey holds. IPDAS 5.0 contains more than these. A criterion absent here has not been assessed and is not passed. Standard: IPDAS 5.0, published 2026-06-12. Assessment is by Values in Care, not by IPDAS or any outside reviewer.
US Preventive Services Task Force. Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(18):1901-1913.
https://doi.org/10.1001/jama.2018.3710
Read 2026-09-11 from the PubMed record (structured abstract of the version of record).
The 2018 statement remains the posted final recommendation, but the Task Force explicitly says this topic is being updated and has published a final research plan for the update.
Method: Direct review of the USPSTF final recommendation page and, where present, the Task Force's in-progress update page.
Not covered: This check establishes what the publisher currently posts. It does not predict the timing or content of a future draft or final recommendation.
US Preventive Services Task Force. Prostate Cancer: Screening. Final Recommendation Statement. May 8, 2018.
Read 2026-09-18 from the USPSTF final recommendation statement (official web page).
The 2018 statement remains the posted final recommendation, but the Task Force explicitly says this topic is being updated and has published a final research plan for the update.
Method: Direct review of the USPSTF final recommendation page and, where present, the Task Force's in-progress update page.
Not covered: This check establishes what the publisher currently posts. It does not predict the timing or content of a future draft or final recommendation.
Each clinical statement above paraphrases one of these sources closely. Filing it under a priority, or reading it against priorities you saved, is a Values in Care editorial operation rather than a source finding.
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