American Cancer Society Recommends PSA Tests Every 2 Years for Men 50-69

Q: Could an elevated PSA test result actually be caused by your daily workout routine rather than prostate cancer?

Yes. An elevated PSA can be caused by your workout routine or other recent activity, not just prostate cancer. PSA is a prostate marker, not a cancer diagnosis. Levels can rise for several noncancerous reasons, including vigorous exercise, especially cycling, recent ejaculation, prostatitis, urinary infection, an enlarged prostate, or recent prostate procedures. Hard workouts that put pressure on the pelvic area can temporarily push PSA up. That is one reason the American Cancer Society’s new guidance says men with a high PSA should repeat the test within two weeks to three months before moving to MRI or biopsy. Many doctors also advise avoiding ejaculation, vigorous exercise and cycling for about 48 hours before a PSA blood draw, and postponing testing if you are sick or have urinary symptoms, because inflammation can skew the result. A single elevated PSA therefore should not be read as proof of cancer. Doctors usually interpret it alongside age, PSA trends over time, family history, ancestry, prostate size, symptoms and sometimes additional tests such as free PSA, PSA density or MRI. What matters most is whether the PSA stays elevated after temporary triggers are removed. If it remains high on repeat testing, MRI is now commonly used to help decide whether a biopsy is needed. Persistent elevation deserves follow-up, but a one-off high result after a long bike ride or intense workout may reflect the exercise rather than cancer.

3 articles · Updated · The Washington Post · Nov 12

Most men ages 50 to 69 should get a PSA blood test every two years under the American Cancer Society’s first prostate-screening update in more than a decade, replacing its prior stance against routine testing.
Black men and those with a family history should start annual PSA screening at 45, while the group still advises against screening men 75 or older or those not expected to live 10 more years.
Elevated PSA results should be rechecked within two weeks to three months and followed by MRI before any biopsy decision, reflecting a shift away from automatic invasive follow-up and overtreatment.
A 160,000-man European study published last year found PSA screening cut prostate-cancer mortality by 13%, helping drive the change even as the U.S. Preventive Services Task Force still favors individual choice.