Disease of aging
Prostate Cancer Screening
Last updated 2026-07-02· Last reviewed 2026-07-02· 1 min read
Reviewed by the Ultimate Longevity Bible editorial team. Educational reference — not medical advice. See disclaimer.
Evidence
- ERSPC (European): PSA screening reduced prostate-cancer mortality by ~20% at 16-year follow-up, at the cost of ~48 over-diagnoses per life saved.
- PLCO (US): null result initially, later shown to be contaminated by control-arm PSA testing.
Contemporary approach
- Shared decision-making from age 50 (or 45 in higher-risk populations — Black men, family history,
BRCAcarriers). - Baseline PSA in 40s to stratify risk.
- Elevated PSA → mpMRI before biopsy to reduce unnecessary sampling.
- Active surveillance for low-risk (Gleason 3+3) disease.
- Stop screening at age 70–75 or when life expectancy < 10 years.
Longevity relevance
Represents the archetypal age-related-cancer screening trade-off: lead-time bias, length bias, and over-treatment of biology that would never have caused death. Genuinely improves outcomes when applied selectively, harms when applied indiscriminately.
- Best Preventive Screening and Imaging by Decade — Best-of guide.
- Best Biomarkers to Track in Your 40s — Best-of guide.
- MoCA (Montreal Cognitive Assessment) — Biomarker.
- Ezra (Whole-Body MRI) — Clinic.
- Prenuvo (Whole-Body MRI) — Clinic.