Which statement best describes PSA-based screening for older men?

• A. Routinely recommended for all men 50-75
• B. Individualized decision-making for men 55-69; not routinely recommended for all; generally not recommended for men 70+
• C. Not routinely recommended for any age
• D. Recommended annually for men 40-60

Answer: (B)

PSA-based screening for prostate cancer isn’t a universal test for older men because the balance of benefits and harms changes with age, life expectancy, and individual values. The guidance emphasizes shared decision-making for those in the 55–69 age range, since some men in this group may benefit from detecting cancer earlier while others may experience more harm from unnecessary tests and treatments. For men 70 and older, the net benefit is generally small or negative, so routine screening is not recommended.

That’s why the best description is that screening decisions should be individualized for men 55–69 and not routinely recommended for all, with screening generally not advised for most men 70 and older. The other statements don’t fit because universal screening for all men in broader age spans ignores the age-specific balance of benefits and harms, and routine annual screening or screening starting at younger ages isn’t supported by current guidelines.