Why is PSA not recommended after age 70?

Why PSA Testing Often Stops at Age 70

For years, the prostate-specific antigen (PSA) test has been a routine part of men’s health screenings, helping detect early signs of prostate cancer. But as men age, the balance between benefit and risk shifts. That’s why many doctors now recommend stopping routine PSA testing after age 70.

The reasoning isn’t about prostate cancer becoming less likely—it’s about life expectancy and quality of life. As Dr. Peter Carroll, a leading urologist at UCSF, explains, “Most men over 70 with elevated PSA levels are unlikely to live another decade, and the cancers we find are often slow-growing.” This means that even if a tumor is detected, it may never cause symptoms or shorten life.

Aggressively screening and treating prostate cancer in older men can lead to more harm than good. Biopsies carry infection risks, and treatments like surgery or radiation can result in incontinence, erectile dysfunction, and other complications. For a man in his 70s or beyond, these side effects may outweigh any potential benefit.

Instead of automatic testing, the focus shifts to personalized care. Doctors consider overall health, family history, and individual risk factors. A man in excellent health at 72 might still benefit from monitoring, while another with multiple chronic conditions may skip it entirely.

Organizations like the U.S. Preventive Services Task Force emphasize shared decision-making for men ages 55 to 69, but suggest that screening generally not be offered beyond age 75. Some clinicians extend that cutoff to 70 based on a patient’s vitality.

In the end, the decision isn’t about age alone—it’s about what matters most: living well, not just living longer. As medical thinking evolves, so does the wisdom in knowing when not to test.