Choosing Wisely®

Prostate Cancer Screening Using a Prostate-specific Antigen (PSA) Test or Digital Rectal Exam


Do not routinely screen for prostate cancer using a prostate-specific antigen (PSA) test or digital rectal exam.

  • There is convincing evidence that PSA-based screening leads to substantial over-diagnosis of prostate tumors.
  • Many tumors will not harm patients, while the risks of treatment are significant.
  • Physicians should not offer or order PSA screening unless they are prepared to engage in shared decision making that enables an informed choice by patients.

This recommendation is provided solely for informational purposes and is not intended as a substitute for consultation with a medical professional. Patients with any specific questions about this recommendation or their individual situation should consult their physician.

About Choosing Wisely®

The Choosing Wisely®(  campaign was created as an initiative of the American Board of Internal Medicine (ABIM) Foundation( to improve health care quality. More than 70 specialty societies have identified commonly used tests or procedures within their specialties that are possibly overused.

Learn more about the AAFP support of the Choosing Wisely® campaign.