Last Updated on November 25, 2025 by
For men over 70, the choice to get a Prostate-Specific Antigen (PSA) test is tricky. Many ask, “my PSA is 56 should I worry, but studies show that routine tests might cause more harm than good. They can lead to overdiagnosis and overtreatment.
The US Preventive Services Task Force says the risks of PSA screening often outweigh the benefits for older men.
Over 80% of prostate cancers in men over 70 grow slowly and don’t shorten their lives. Because of this, hospitals like LIV Hospital are thinking differently about patient care. They’re looking at the risks and benefits of PSA screening.
We’ll look at the guidelines and thoughts on PSA screening for older men. This will help us understand when to worry and when not to.
Key Takeaways
- The US Preventive Services Task Force recommends against routine PSA screening for men aged 75 and older.
- PSA screening in older men can lead to overdiagnosis and overtreatment.
- More than 80% of prostate cancers in men over 70 are slow-growing.
- Top hospitals are reevaluating their approach to PSA screening for older men.
- Understanding psa levels by age and normal psa levels by age is key for making informed choices.
Understanding PSA Testing and Age-Related Guidelines
Age plays a big role in PSA testing guidelines. It’s key to understand how age affects PSA test results. Knowing the basics of PSA testing and its age-related aspects is vital for prostate health.
What is PSA and How is it Measured?
The Prostate-Specific Antigen (PSA) test checks PSA levels in the blood. PSA is a protein made by the prostate gland. High levels might mean prostate cancer, prostatitis, or BPH. The test takes a blood sample from a vein in the arm.
Knowing the normal PSA range is important. It changes with age. A PSA under 4 ng/mL is usually normal, but age and individual factors can affect this. For example, men over 60 should aim for a PSA under 3 ng/mL to be at low risk. Also, PSA levels can change for many reasons, like some medicines, medical procedures, and even ejaculation.
Current Medical Guidelines for PSA Screening by Age
Guidelines from the US Preventive Services Task Force and other cancer groups say no routine PSA screening for men over 70, unless they’re at high risk. For men 55 to 69, the choice to get a PSA test depends on their risk, health, and how long they might live.
Here’s a quick summary of PSA screening by age:
- Men under 40: No routine PSA screening is needed because prostate cancer risk is low.
- Men between 40 and 54: The choice to get a PSA test depends on their risk factors.
- Men between 55 and 69: It’s best to make a personal decision, thinking about health and life expectancy.
- Men over 70: Routine PSA screening is usually not advised, except for those at high risk or with a long life expectancy.
5 Reasons Why PSA Testing is Not Recommended After Age 70
After 70, the need for PSA testing is questioned. This is because of the risk of finding cancers that won’t harm you. We’ll look at why doctors often don’t suggest PSA tests for men over 70.
Limited Life Expectancy Benefit vs. Treatment Risks
PSA tests in older men might not add much to their life span. But, treatments can have big risks. The Canadian Task Force says the downsides often outweigh the upsides for men over 70.
“The harms of screening, including overdiagnosis and overtreatment, are concerning in older men,” recent guidelines warn. This is because they’re more likely to die from other causes.
High Rate of Slow-Growing Cancers in Older Men
Older men often have cancers that grow slowly and won’t shorten their life. These cancers might lead to treatments that aren’t needed. It’s important to think about the cancer’s type and growth chance before screening.
Increased Risk of False Positives with Age
As men get older, the chance of false positives goes up. This can cause worry and extra tests, like biopsies. These tests can have risks too. For men over 70, this is a big worry.
Overdiagnosis and Unnecessary Treatment Concerns
PSA tests can find cancers that aren’t deadly. Treating these can cause problems like incontinence and impotence. We must think about the chance of overdiagnosis before testing.
Additional Risks and Considerations
There are more risks to think about too. Older men might have other health issues that make treatment harder. We need to look at the whole picture when deciding on PSA tests for them.
In short, while PSA tests have their uses, they might not be right for men over 70. Knowing these reasons helps us make better choices about prostate screening.
“My PSA is 56 Should I Worry” – Interpreting High PSA Levels at Different Ages
Understanding PSA test results is complex. It involves knowing how age and health affect them. PSA levels change with age, so it’s key to know what’s normal at each stage.
Normal PSA Ranges by Age Group
PSA levels are measured in nanograms per milliliter (ng/mL). The normal range changes with age. For example, a man in his 50s should have a PSA under 2.5 ng/mL. But for a 70-year-old, up to 6.5 ng/mL is often seen as normal.
Knowing the PSA range by age is essential. For a normal PSA for a 75-year-old man, the number can be higher than for younger men. Men aged 70-79 with a PSA up to 6.5 ng/mL are usually considered normal, but health and other factors play a role.
When High PSA Levels Warrant Concern vs. Monitoring
A PSA of 5.6 ng/mL might be high for a young man but okay for an older one, depending on health. Whether to worry or just monitor depends on many things. These include how fast the PSA is rising, overall health, and risk for prostate cancer.
Men with a PSA slightly above normal might just need regular checks. This helps catch any big changes early, like signs of prostate cancer or other issues.
Non-Cancer Causes of Elevated PSA Levels
High PSA levels don’t always mean cancer. Conditions like prostatitis or BPH can also raise PSA. So, a full check-up is needed to find out why PSA is high.
Knowing about PSA values by age and why they might be high helps men make better health choices. It’s important to talk about PSA results with a doctor, taking into account overall health and risk factors.
Exceptions: When PSA Testing May Be Appropriate After 70
Even though guidelines say not to test for PSA after 70, there are times when it’s okay. Your health situation can change whether you should get tested or not.
Individual Risk Assessment Factors
Some men might need to keep getting PSA tests after 70. This includes those with a history of prostate cancer, a family history, or other health issues.
“The decision to continue PSA screening should be based on a man’s overall health and life expectancy,” doctors say. This helps figure out if the good from testing is worth the risks.
Men with High-Risk Profiles or Family History
Men at high risk or with a family history of prostate cancer might see more benefits from testing. They should talk to their doctor to decide what’s best for them.
- Family history of prostate cancer
- Genetic predispositions (e.g., BRCA1 and BRCA2 gene mutations)
- Previous history of prostate cancer or high-grade prostatic intraepithelial neoplasia (HGPIN)
These men might need to keep getting checked because they’re at a higher risk of getting prostate cancer.
Discussing PSA Testing with Your Doctor After 70
Men over 70 should talk to their doctor about PSA testing. They should think about their health, how long they might live, and what they want.
“Shared decision-making is key when it comes to PSA testing in older men. Patients should be fully informed about the possible benefits and harms of screening,” clinical guidelines say.
Talking openly with your doctor helps make choices that fit your unique situation.
Conclusion: Making Informed Decisions About Prostate Screening
Understanding PSA testing is key to making smart choices about prostate screening. We’ve looked at the latest guidelines and what affects the decision to screen, mainly after age 70.
Deciding on a prostate exam depends on your health, risk factors, and how long you might live. Even though routine PSA tests aren’t usually advised after 70, some men might need them. This is based on their age and health situation.
We suggest men talk to their doctors about their options. This way, they can choose what’s best for their health and values. They should keep in mind the latest guidelines and what’s recommended for their age.
FAQ
What is a normal PSA level for a man over 70?
PSA levels usually go up with age. A PSA under 4.0 ng/mL is often seen as normal. But, it can change based on your health and other factors.
What does a PSA level of 5.6 mean?
A PSA of 5.6 is higher than normal. It might mean you need more tests or checks, based on your health and other factors. Always talk to your doctor about it.
Why is PSA screening not recommended for men over 70?
The US Preventive Services Task Force says not to screen men over 75 with PSA tests. This is because it might lead to too many treatments and not much benefit in life expectancy.
What are the risks associated with PSA screening in older men?
There are risks like false positives and unnecessary treatments. These can cause anxiety and harm your quality of life. It’s also about overdiagnosis and overtreatment.
Are there exceptions to the guideline against PSA screening after 70?
Yes, some men might need to keep getting screened. This includes those with a high-risk profile, family history, or specific health issues. Talk to your doctor about your situation.
How often should a man get his prostate checked?
How often you get checked depends on your risk, age, and health. Talk to your doctor to figure out the best plan for you.
What is considered a high-risk profile for prostate cancer?
A high-risk profile includes a strong family history of prostate cancer, certain genetic markers, or other health issues. If you think you might be at risk, talk to your doctor.
How do I discuss PSA testing with my doctor after 70?
Have a detailed talk with your doctor about PSA testing. Think about the benefits and risks, and your health, risk factors, and what you prefer.
References
- U.S. Preventive Services Task Force. (2018, May 8). Final recommendation statement: Prostate cancer screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening
- Kalavacherla, S., Liss, M., Porter, J., & Keeter, M. (2023). Low-Value Prostate-Specific Antigen Screening in Older Males. JAMA Network Open, 6(10), e2336767. https://doi.org/10.1001/jamanetworkopen.2023.36767
- American Cancer Society. (2023, November 22). Prostate Cancer Detection (PSA Testing) Recommendations. https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/acs-recommendations.html
