the current thought is that any male who lives long enough will eventually develop prostate cancer
the problem with prostate cancer screening is that it's hard to differentiate BPH , benign prostate hyperplasia from outright cancer except with biopsies. blood tests are one tool, but when it is elevated a biopsy is done and it's oftentimes just BPH. things like infection or trauma can elevate it too
so right now there are no firm guidelines besides it is suggested that some type of exam is done after age 50, whether rectal exam or PSA
if PSA is elevated then the discussion with the patient comes up with the choices being watchful waiting and following the level, or doing a biopsy
this is all predicated on symptoms, if there's no urinary symptoms, there's much less concern for either BPH or cancer
there actually is a lot of debate within western medicine as to how to approach prostate cancer screening, and like most of western medicine nowadays, most err on the side of being more aggresive, because you get sued otherwise
" But doctor, isn't there a simple blood test you could have done to check for prostate cancer? Why didn't you do it for my client?"
bam, $7 million settlement