An official website of the United States government
Data Up to Date as of:
On This Page:
Background
Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in a man’s blood. For this test, a blood sample is sent to a laboratory for analysis.
In 2012 the U.S. Preventive Services Task Force (USPSTF) recommended against prostate cancer screening. In May 2018, the USPSTF published a final recommendation statement to update PSA screening guidelines for two subsets of the population:
- for men age 70 years and older, the USPSTF recommends against PSA-based screening for prostate cancer, and
- for men ages 55 to 69 years, the USPSTF recommends that clinicians inform them about the potential benefits and harms of PSA-based screening for prostate cancer, stating that the decision about whether to be screened for prostate cancer should be an individual one.
Measure
The percentage of men aged 55 to 69 years who reported having had a PSA test within the past year, by race/ethnicity, income, education level, and age. This provides information about the use of PSA testing in the population.
Measurement challenges
We track prostate cancer screening rates in U.S. using a large, national, in-person survey in which male respondents were asked several questions about prostate cancer and PSA testing, including whether they had ever had a PSA test and, if so, the time of their most recent test and the main reason for undergoing it (see Data Source, below). There are important limitations to this method that impact what information we can accurately collect and how confident we can be in the findings. Studies have found that certain types of healthcare survey questions can be difficult for people to clearly understand and answer, and it is easy for some questions to be misinterpreted.
In the case of PSA screening, it may be challenging to determine by self-report alone if a PSA test was received for screening purposes, i.e., to look for asymptomatic, previously undetected cancer, or for diagnostic purposes, i.e., as a follow up on symptoms or suspicious findings from a prior test. Additionally, looking for new or recurrent asymptomatic cancer in a person previously diagnosed and treated for that cancer type represents a third type of testing known as surveillance testing. In some cases, because PSA testing is a blood test, it may be bundled by a clinician with other tests, and a man may be unaware he even had the test. Finally, men may also not always accurately recall the specific time they received a particular test. As such, our measure captures any type of PSA test received by a man, and the population may include those with a prior diagnosis of prostate cancer. This serves as a reasonable approximation, although an overestimate, of the true U.S. prostate cancer screening rate.
Even though the National Health Interview Survey prostate cancer screening measures have limitations, it is the best nationally representative data we have available to assess prostate cancer screening rates.
Healthy People 2030 Target
There is no Healthy People 2030 target related to being screened for prostate cancer. There is a target goal to increase the proportion of men who have discussed the advantages and disadvantages of the PSA test to screen for prostate cancer with their health care provider.
Healthy People 2030 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.
Data Source
Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 2005-2021.
In 2019 the NHIS questionnaire was redesigned to increase relevance, enhance data quality, and minimize respondent burden. In addition, the COVID-19 pandemic created challenges conducting in-person interviews for the 2020 NHIS, requiring changes to field procedures to conduct most surveys by telephone, which impacted survey response rates. For details related to the potential impacts of these issues, please refer to Potential Impact of NHIS Redesign and COVID-19 on the Cancer Trends Progress Report.
Trends and Most Recent Estimates
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2021) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
All Races/Ethnicities
|
37.1 | 35.1 - 39.1 |
Non-Hispanic White
|
40.7 | 38.5 - 42.9 | |
Non-Hispanic Black
|
32.7 | 27.0 - 38.9 | |
Hispanic
|
29.1 | 23.0 - 36.1 | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2021) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
<200% of federal poverty level
|
22.7 | 19.3 - 26.4 |
>=200% of federal poverty level
|
41.0 | 38.7 - 43.3 | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2021) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Less than High School
|
21.7 | 16.8 - 27.5 |
High School
|
35.8 | 32.1 - 39.6 | |
Greater than High School
|
40.3 | 38.0 - 42.8 | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2021) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Ages 40-54
|
10.5 | 9.4 - 11.8 |
Ages 55-69
|
37.1 | 35.1 - 39.1 | |
Ages 70+
|
48.8 | 46.4 - 51.1 | |
Additional Information on Prostate Cancer Screening
- Prostate Cancer Screening Final Recommendations. U.S. Preventive Services Task Force.
- Prostate-Specific Antigen–Based Screening for Prostate Cancer Evidence Report and Systematic Review for the US Preventive Services Task Force. Fenton JJ, Weyrich MS, Durbin S, et al. JAMA 2018;319(18):1914-1931. doi:10.1001/jama.2018.3712
- Extended follow-up for prostate cancer incidence and mortality among participants in the Prostate, Lung, Colorectal and Ovarian randomized cancer screening trial. Pinsky PF, Miller E, Prorok P, et al.BJU Int 123 (5): 854-860, 2019.
- A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer. Hugosson J, Roobol MJ, Månsson M, et al.Eur Urol 76 (1): 43-51, 2019.
- SEER Cancer Stat Facts: Prostate Cancer. National Cancer Institute.
- Behavioral Risk Factor Surveillance System: Prevalence Data & Data Analysis Tools. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion.