Decision box

Men between the ages of 55 and 69 with at least a 10-year life expectancy. Screening is appropriate for people who do not carry a disease that affects their life expectancy.

• The prostate-specific antigen (PSA) blood test is used to screen men for prostate cancer. The PSA blood test estimates the risk of having prostate cancer.

• It is prescribed by a doctor or a nurse practitioner.

A PSA equal to or greater than 4 ng/mL increases the risk of having prostate cancer.

If the PSA is less than 4 ng/mL, then the man may be asked to repeat the test in a few years.

1. If the PSA is equal to or greater than 4 ng/mL, the physician may suggest a biopsy of the prostate to verify whether the person really has prostate cancer. The person may choose not to undergo the biopsy and to actively monitor his situation instead by making new screening tests at regular intervals. 

2. If the man opts to undergo a biopsy, which then reveals the presence of prostate cancer, he has a number of options:

   • Do not treat and choose active surveillance instead by making new screening tests at regular intervals

   • Undergo surgery to remove the prostate

   • Undergo radiotherapy treatment

According to your priorities, you can choose whether or not to be screened. The choice is up to you because...

• Both options have harms and benefits
• Both options are acceptable: Major clinical guidelines (INESSS, USPSTF, AUA, ACP, CUA)* recommend informed, shared decision-making between the health professional and the patient.

*INESSS : Institut national d'excellence en santé et services sociaux;
USPSTF: United States Preventive Services Task Force;
AUA: American Urological Association;
ACP: American College of Physicians;
CUA: Canadian Urological Association;
Canadian Task Force on Preventive Health Care.