Know the Guidelines for Prostate cancer screening, high risk categories and follow ups.

There are three levels of risk: General population, High risk and very high risk. The guidelines for all of them are outlined below.

General Population: Current screening recommendations are annually beginning at 50 y/o age for men who have a life expectency of 10 yrs or more.
Since PSA is prostate tissue specific and not prostate CA specific it can be high in BPH and in prostatitis too.
For men with PSA levels above 10, do a trans-rectal biopsy. For levels between 4 and 10 ng/ml check free PSA. If it is less than  20% do biopsy.
Lowering the threshold to to 2.5 ng/ml leads to detection of early disease but also increases the Bx rate

In high risk groups (1. African subsaharan and 2. men with 1 first degree relatives with prostate CA) recommended screening is at 45 y/o age

In those at very high risk, (if there are multiple relatives with prostate CA) recommendations are to begin screening at 40 y/o age. If PSA is < 1.0 then no need for additional testing until 45 y/o age. If PSA >1.0 ng/ml but < 2.5 then screen annually. If PSA > 2.5 ng/ml proceed with Bx