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Prostate cancer

Rethinking Prostate Cancer Screening After 70: Is Routine Testing Still Necessary?

Strategic Insights

— 1 min read

Routine prostate-specific antigen (PSA) screening has been used to detect prostate cancer early, but a new study suggests that continuing PSA tests after age 70 may not be beneficial, especially for men with low baseline PSA levels in their mid-60s. The study, published in the JAMA Network Open in February 2025, found that nearly two-thirds of men aged 70+ continued to receive PSA tests, despite recommendations against routine screening in older age. The study's findings indicate that men with low PSA levels at age 65-69 have a less than 1 in 1,000 chance of dying from prostate cancer in the next 10 years, suggesting that many older men are still getting screened unnecessarily.

Key Takeaways:

  • 64.4% of men aged 70+ continued to receive PSA tests, despite recommendations against routine screening in older age
  • Men with low PSA levels at age 65-69 had a less than 1 in 1,000 chance of dying from prostate cancer in the next 10 years
  • PSA levels in the late 60s are strong predictors of future risk, and may help guide decisions about stopping screening
  • Approximately 0.1% of men with low PSA levels (under 1 ng/mL) died from prostate cancer in the next 10 years
  • 0.5% of men with low PSA levels had metastatic prostate cancer
  • Men with PSA levels 2 ng/mL or higher at 65-69 had a 1.5% chance of prostate cancer-specific mortality and a 5.4% chance of metastatic cancer
  • Continuing screening in men with little risk increases the chance of overdiagnosis, leading to unnecessary biopsies, anxiety, and treatments that may cause urinary or sexual side effects

Statistics:

  • 33.8% of men aged 80+ continued to receive PSA tests
  • 41.3% of men aged 75+ continued to receive PSA tests
  • 47.4% of men aged 70+ continued to receive PSA tests
  • 827,000 U.S. veterans aged 70+ were included in the study
  • Participants were followed for a median of 8.1 years
  • 64.4% of men aged 70+ had PSA levels under 1.5 ng/mL at age 65-69
  • 1.5% of men with PSA levels 2 ng/mL or higher at 65-69 died from prostate cancer in the next 10 years

Sources:

  • Prostate Cancer Mortality in Men Aged 70 Years Who Recently Underwent Prostate-Specific Antigen Screening - (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2830234)

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