The Prostate Exam: How often should men get a prostate test for prostate cancer?          

According to the Cancer Council Australia, men aged 50 to 69 are recommended to have a prostate-specific antigen (PSA) blood test every two years [1]. Men with a family history of prostate cancer or other risk factors are at a higher risk and may need to begin prostate cancer screening earlier, around age 45, to catch signs of prostate cancer [1]. Men with three affected first-degree relatives diagnosed with prostate cancer are considered high risk and are recommended to begin screening every 2 years from the age of 40. [2]. Regular PSA tests and potential follow-up with a DRE help monitor prostate health and check for any abnormalities in the prostate gland [3].

Dr. Gordon O'Neill, a urologist with over 25 years of experience, stresses the simplicity and importance of these exams.

He explains:
“Prostate examinations are really quite simple, and they don’t take very long. They may be transiently uncomfortable, but they provide us with a lot of crucial information. For example, a DRE helps detect non-PSA producing prostate cancers, and also helps us understand the size of the prostate.”

A PSA test measures the level of prostate specific antigen in the blood [4], which can indicate prostate cancer or other conditions like benign prostatic hyperplasia (BPH). Traditionally, a PSA level of 4.0 ng/mL or lower is considered normal PSA, but high PSA levels may require further testing, such as a biopsy, to rule out cancer [5].

Elevated PSA levels could also point to benign prostatic hyperplasia (BPH), urinary tract infections (UTIs), or injury to the prostate region [4].

As Dr. O'Neill notes:
“BPH is a condition that affects most men as they age. It involves the gradual enlargement of the prostate in a benign, non-cancerous way. This slow growth can eventually block the bladder outlet, causing urinary symptoms.” He adds, "A PSA test is vital because it’s elevated in all prostate diseases, and helps us screen for prostate cancer before considering any BPH treatment."

For more information, refer to our ultimate Benign Prostatic Hyperplasia (BPH) guide.

What is PSA?

Prostate-specific antigen is a protein that is produced by the prostate gland. A PSA test is a blood test [3] to check whether an individual has high levels of it. Those who have been found to have high levels of PSA may be likely to have issues related to their prostate [4].

According to Cancer Australia [6], prostate cancer was the most commonly diagnosed cancer in the country in 2023. It’s estimated that Australian men have a 1 in 6 (or 17%) risk of being diagnosed with prostate cancer by the age of 85.

Men with a family history of prostate cancer, especially if their father or brother has been diagnosed with prostate cancer, are at a higher risk [7]. 

According to Dr. O'Neill, a urologist may recommend early PSA screening or more frequent tests for these individuals for early detection of prostate cancer.

In addition to family history, obesity, a Western diet high in fatty foods, and lack of exercise are contributing risk factors for prostate cancer [7]. 

An enlarged prostate or BPH is a common condition among older men, but BPH is not directly linked to prostate cancer. However, both conditions can share similar symptoms including:

• Frequent urination, especially at night
• Urgent need to urinate
• Difficulty starting or maintaining a urine flow
• Weak or interrupted urine stream
• Feeling of incomplete bladder emptying

As Dr. O'Neill explains:
“BPH is almost universal as men age, starting from age 40 onwards. It can cause obstructive symptoms like poor urine flow, hesitancy, and dribbling, as well as frequency and urgency issues due to an overactive bladder.”

If you experience these symptoms, a healthcare provider may recommend a PSA test or further diagnostic testing, such as an ultrasound, to assess the prostate but it's best for men to talk to their doctor about next steps.

In some cases, more testing is recommended. Advanced imaging may provide a multidimensional view of the prostate for a more detailed diagnosis and treatment plan.

Early detection is key for both conditions so you can make an informed decision. If you're experiencing any potential symptoms of prostate enlargement, Mosh offers a free enlarged rostate health check to help determine the next steps.

Advanced Imaging for Prostate Health

In some cases, clinics use advanced imaging techniques like robotic software systems that combine ultrasound and camera images for BPH treatment. These techniques give urologists a multidimensional view of the prostate [8], allowing for customised treatment plans. Prostate volume is typically measured using an ultrasound, and an enlarged prostate is diagnosed when its volume exceeds 30 mL [9].

Dr. O'Neill adds that unlike prostate cancer, BPH can be a benign condition, but symptoms like poor flow or incomplete bladder emptying shouldn’t be ignored:

“Men often assume that poor flow or getting up multiple times at night is just part of aging, but once diagnosed, we can help improve your symptoms significantly.”

At Mosh, you can get started on your prostate health checks, with comprehensive online assessments and specialist referrals, all in the one place. It just starts with a quiz!

An enlarged prostate can be diagnosed through imaging techniques like ultrasound, CT, or MRI. A normal prostate is about the size of a walnut or ping-pong ball (around 30 grams). An enlarged prostate can grow to the size of a tennis ball or larger.

When it comes to having an ultrasound, you may hear the radiographer refer to it as prostatomegaly [10], which is a general term used to describe enlargement of the prostate gland from whatever cause. 

Ultrasound measures the prostate volume using the ellipsoid formula, and an enlarged prostate is usually classified as having a volume greater than 30 mL. The volume of the prostate can be estimated on ultrasound, CT and MRI with the ellipsoid formula measuring each length in centimetres: (Width x height x length x 0.523) [11].

If you experience symptoms of prostate problems, such as difficulty urinating or pain, consult your healthcare provider promptly. Early detection improves treatment outcomes for both BPH and prostate cancer.

• Consult Your GP: Discuss symptoms and risk factors.
• Specialist Referral: You may be referred to a urologist for further evaluation.
• Prostate Health Quiz: Consider taking a quiz to assess your symptoms and risk.

At Mosh, you can get prostate health checks, comprehensive online assessments and specialist referrals, all in the one place. It just starts with a quiz!

Not only that, Mosh is an online health platform that provides personalised treatments for hair loss, weight management, skincare and sexual health—helping you take control of your well-being, all in one place.