As men grow older, certain health screenings become more important and more complex. One of the most frequently debated topics among men over 70 and their healthcare providers is prostate cancer screening.
If you’re wondering, “Is it common to test for prostate cancer after 70?”, you’re not alone.
In this post, we’ll explore what the latest medical guidelines say, the reasoning behind testing or not testing after 70, the risks and benefits involved, and how men can make the best decision for their health with their doctors.
Understanding Prostate Cancer and Its Risk with Age
Prostate cancer is the second most common cancer among men worldwide, particularly affecting older males. The risk of developing prostate cancer increases significantly with age, especially after 50. According to the American Cancer Society:
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About 60% of prostate cancers are diagnosed in men aged 65 or older.
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The average age at diagnosis is about 66 years.
This means that even after 70, men are still very much at risk of developing prostate cancer. However, whether or not it’s advisable—or necessary—to screen for it at that age is where the conversation gets interesting.
What Is Prostate Cancer Screening?
Prostate cancer screening usually involves:
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PSA Blood Test (Prostate-Specific Antigen): Measures the level of PSA in the blood, which may be elevated in men with prostate cancer.
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Digital Rectal Exam (DRE): A physical exam where a doctor checks the prostate for abnormalities.
These tests help detect prostate cancer at an early stage when treatment is more likely to be effective. However, not all prostate cancers are life-threatening or aggressive.
Is It Common to Test for Prostate Cancer After 70?
The Short Answer: It Depends
While it is not uncommon, routine testing for prostate cancer after the age of 70 is not universally recommended. Many leading health organizations have issued guidelines suggesting individualized screening based on a person’s health status, life expectancy, and personal preferences.
What Do the Medical Guidelines Say?
Let’s look at what major medical bodies say about screening men over 70:
1. U.S. Preventive Services Task Force (USPSTF)
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Recommends against routine PSA-based screening for men 70 and older.
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The reasoning is that the benefits of screening are limited in this age group, and potential harms outweigh the advantages.
2. American Urological Association (AUA)
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Does not recommend routine screening for men over 70 or any man with less than a 10-15 year life expectancy.
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However, it emphasizes shared decision-making for healthy older men.
3. American Cancer Society (ACS)
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Suggests that screening decisions should be made between the doctor and patient, particularly for men in excellent health who may benefit from early detection.
In short, testing is not ruled out, but it is not automatically recommended either.
Why the Hesitation to Test After 70?
There are several valid reasons why routine prostate cancer screening is not automatically recommended after age 70:
1. Slow-Growing Nature of Prostate Cancer
Most prostate cancers are slow-growing and may not cause significant harm or symptoms during a man’s remaining lifetime, especially if he’s already in his 70s or older.
2. Overdiagnosis and Overtreatment
Screening can detect cancers that may never cause symptoms, leading to unnecessary anxiety, treatments, and side effects such as incontinence or erectile dysfunction.
3. Life Expectancy Considerations
If a man is not expected to live more than 10-15 years, it’s unlikely that finding and treating prostate cancer will significantly improve his quality or length of life.
4. Risks of Biopsy and Treatment
Follow-up procedures after a positive screening—such as a prostate biopsy—can come with risks, including infections, bleeding, and complications from surgery or radiation.
When Might Testing Still Be a Good Idea After 70?
While routine testing may not be the norm, there are important exceptions where screening may still be beneficial for men over 70:
✅ Excellent Overall Health
A 72-year-old marathon runner with no major chronic illnesses may live for 20+ more years. For him, screening could detect a potentially dangerous cancer in time for effective treatment.
✅ Family History
Men with a strong family history of prostate cancer—especially aggressive forms—may be at higher risk and should discuss screening options with their doctor.
✅ African American Men
African American men have a higher risk of developing and dying from prostate cancer, and may benefit from continued vigilance, even after 70.
✅ Elevated PSA Levels in the Past
If a man has had elevated PSA levels in previous years, monitoring may be advisable to catch potential changes early.
Benefits of Screening After 70
If done for the right reasons and in the right individual, prostate cancer screening after 70 can offer the following benefits:
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Early detection of aggressive cancers
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Potential for less invasive treatment
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Peace of mind from knowing your PSA levels are stable
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Opportunity for personalized monitoring
Risks and Downsides of Screening After 70
On the flip side, here are some potential risks of screening men over 70:
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False positives leading to unnecessary biopsies
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False negatives giving a false sense of security
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Psychological stress over inconclusive results
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Complications from treatments that may not be needed
How Should Older Men Decide?
Talk to Your Doctor
The best approach is shared decision-making. You and your healthcare provider should weigh the pros and cons based on:
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Current health
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Family history
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Life expectancy
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Risk tolerance
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Previous screening history
Ask Yourself
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Am I healthy enough to live another 10-15 years?
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Would I want to know if I had prostate cancer, even if it’s slow-growing?
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Am I willing to go through potential biopsies or treatments?
Alternatives to Routine Screening
For some men over 70, an alternative approach may include:
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Active Surveillance: Regular monitoring without immediate treatment.
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Watchful Waiting: Less intensive monitoring for men with limited life expectancy.
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One-Time Screening: If never screened before, a one-time PSA test could help identify potential red flags.
Final Thoughts
So, is it common to test for prostate cancer after 70? The answer is: it depends on the individual. While routine screening is less common after 70, it’s not off the table, especially for men in excellent health or at higher risk.
Ultimately, the decision should be personal, informed, and guided by your doctor. Rather than a one-size-fits-all answer, screening after 70 should be about what’s best for yo,u your body, your values, and your future.
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