Should I have a PSA test at 78?

PSA Testing at 78: Is It Right for You?

At 78, the question of whether to have a PSA (prostate-specific antigen) test is an important one—but current medical guidance offers a clear direction. The U.S. Preventive Services Task Force (USPSTF), a leading authority on preventive care, recommends against routine prostate cancer screening for men aged 70 and older. This includes those who are 78.

The reason? While early detection sounds beneficial, the potential harms often outweigh the benefits in older age. PSA screening can lead to false positives, unnecessary biopsies, and treatments that carry risks—such as incontinence or sexual dysfunction—without necessarily extending life. Prostate cancer in older men often grows slowly, and many will die with it rather than from it, especially when other health conditions are present.

Every man’s health journey is different. If you're in excellent health at 78, with a life expectancy over 10–15 years, and you’ve discussed prostate screening thoroughly with your doctor, a personalized approach might still include PSA testing. But this is the exception, not the rule.

The key is informed, shared decision-making. The USPSTF strongly emphasizes talking with your clinician about your individual risks, values, and overall health before deciding. At your age, focusing on quality of life and managing existing conditions may be more impactful than routine cancer screening.

In short: routine PSA testing is not recommended for men 70 and older—including those at 78. But your personal health picture matters. Have the conversation. Get the facts. Then decide—carefully—what’s best for you.