A prostate exam usually means a digital rectal exam (DRE), often combined with a PSA blood test, to check for prostate cancer and other prostate problems. It’s quick, and knowing what to expect makes it much easier.
Here’s what happens, when to start screening and what the results mean. Check your knowledge with the prostate exam quiz.
Key takeaways
- A DRE takes less than a minute; the PSA is a simple blood test.
- USPSTF: men 55–69 should decide about PSA screening together with their clinician.
- The American Cancer Society suggests starting the conversation at 50, or at 40–45 for higher-risk men.
- A high PSA is not a diagnosis; only a biopsy can confirm cancer.
USA Prostate Exam: Quick Facts
- Tests
- Digital rectal exam (DRE) + PSA blood test
- DRE time
- Under 1 minute
- USPSTF (55–69)
- Individual decision (Grade C)
- USPSTF (70+)
- Recommends against routine PSA screening
- Higher risk
- Black men; father/brother diagnosed before 65
- Medicare
- Yearly PSA ($0) and DRE for men 50+
What Is a Prostate Exam?
The prostate is a walnut-sized gland below the bladder. A prostate exam checks it for enlargement, lumps or hard areas that could signal benign prostatic hyperplasia (BPH), prostatitis or cancer.
More on What Is a Prostate Exam →What Happens During a Prostate Exam
- You stand and bend forward, or lie on your side with your knees drawn up.
- The clinician inserts a gloved, lubricated finger into the rectum.
- They feel the prostate’s size, shape and texture, which takes just seconds.
- You may feel pressure or a brief urge to urinate, but it shouldn’t be painful.
Pro tip
Tell your clinician if you feel anxious or have hemorrhoids or pain. They can go slower and explain each step.
Rectal Exam (Digital Rectal Exam) Explained
A rectal exam, or digital rectal exam (DRE), is when a clinician inserts a gloved, lubricated finger a short way into the rectum. Besides checking the prostate, it can help evaluate:
- Rectal bleeding, hemorrhoids and fissures
- Lumps or masses in the lower rectum
- Anal sphincter tone (for example with incontinence or certain nerve injuries)
- Constipation or impaction
Good to know
A DRE alone is not a colorectal cancer screening test. Screening uses colonoscopy or stool-based tests, starting at age 45 for most adults.
The PSA Test
The PSA (prostate-specific antigen) test measures a protein in your blood. Higher levels can come from cancer, but also from BPH, prostatitis, recent ejaculation or vigorous cycling. That’s why doctors often repeat an elevated test before moving on to MRI or biopsy.
More on The PSA Test →When Should You Get a Prostate Exam?
| Guideline | Recommendation |
|---|---|
| USPSTF, men 55–69 | Make an individual decision about PSA screening after discussing benefits and harms |
| USPSTF, men 70+ | Recommends against routine PSA-based screening |
| American Cancer Society, average risk | Discuss screening starting at age 50 |
| ACS, higher risk (Black men; father/brother diagnosed before 65) | Discuss starting at 45 |
| ACS, even higher risk (several close relatives diagnosed young) | Discuss starting at 40 |
Many men have this conversation during their annual physical exam.
More on When Should You Get a Prostate Exam →Prostate Exam Results and Next Steps
- Normal: continue screening as agreed with your clinician.
- High PSA or abnormal DRE: repeat the PSA, and possibly an MRI, then a biopsy if needed.
- Cancer found: it is graded (Gleason score / Grade Group). Many low-risk cancers are managed with active surveillance instead of immediate treatment.
Prostate Exam Cost and Coverage
Medicare Part B covers a yearly PSA blood test (usually $0) and a DRE (subject to the deductible and coinsurance) for men 50 and older. Many private plans cover screening under their preventive benefits. Without insurance, a PSA test often costs about $30–$100 plus the office visit.
More on Prostate Exam Cost and Coverage →Free practice test
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Choose your test length, practice with instant feedback or take it exam-style, and get your score with an explanation for every answer.
Go to the USA Prostate Exam practice test →USA Prostate Exam FAQs
Should you poop before a prostate exam?
There’s no need to prepare. A digital rectal exam takes under a minute, and clinicians are used to small amounts of stool. Using the bathroom beforehand is fine if it makes you more comfortable.
Full answer →What is a rectal exam?
A digital rectal exam is a quick check where a clinician inserts a gloved, lubricated finger into the rectum to feel the prostate or lower rectum. It’s used for prostate checks and for symptoms like rectal bleeding.
Full answer →Does a prostate exam hurt?
Usually not. Most men feel brief pressure or discomfort for a few seconds.
Full answer →At what age should men get a prostate exam?
USPSTF says men 55–69 should decide individually about PSA screening. The ACS suggests starting the discussion at 50 for average risk, 45 for higher risk and 40 for very high risk.
Full answer →What is a normal PSA level?
There’s no single cutoff. Levels under about 4 ng/mL have traditionally been considered normal, but doctors interpret PSA based on age, prostate size and trends over time.
Full answer →Is a PSA test better than a DRE?
They check different things and are often used together. Guidelines focus mainly on PSA-based screening, while a DRE can detect some abnormalities that PSA misses.
Full answer →Does Medicare cover prostate exams?
Yes. Medicare Part B covers a yearly PSA test and DRE for men 50 and older.
Full answer →At what age should you get a prostate exam?
Current guidelines suggest discussing prostate cancer screening with a clinician at 55–69, or starting at 40–45 for Black men or those with a strong family history. The PSA blood test is the main screening tool.
Full answer →Official sources
Disclaimer: This guide is for general information and is not medical advice. Coverage, prices and requirements change and vary by provider and location. Confirm details with your provider, insurer or the agency listed in the sources. Read our editorial policy.