The Fear, Misinformation and Stigma Behind Prostate Cancer Screening Rates

Prostate cancer is the most common cancer diagnosed in men in the United States, yet many men remain unaware of just how significant that burden is, according to Lorelei Mucci, Sc.D., a prostate cancer researcher, professor of epidemiology at Harvard T.H. Chan School of Public Health and director of Strategic Research Partnerships at the American Cancer Society. In honor of Prostate Cancer Awareness Month, she said one of the biggest barriers to screening isn’t fear of the test itself, but confusion about what screening actually involves. “The screening for prostate cancer is a simple blood test,” Mucci said. “I think it is this fear of the unknown of what is really entailed with prostate cancer screening.”

She also noted that outdated associations with screening, particularly the digital rectal exam, which is no longer part of standard screening protocols, continue to shape how some men perceive the process, even though it no longer reflects current practice. “For some patients, they’re worried about a biopsy and what that is,” she said, describing a layered sense of apprehension that builds around each successive step of the screening pathway rather than the initial blood test itself.

An “It Won't Happen to Me” Mentality

Mucci pointed to a broader pattern in how men engage with their own health care. “I think my sense is, and we see this a lot, for example, for breast cancer, that women advocate more for their own health,” she said. That gap shows up in a striking statistic: Men who are married or partnered are significantly more likely to get screened for prostate cancer than men who are unmarried, widowed or divorced. “Having a female partner in one’s life, those individuals are much more likely to get screened,” Mucci said.

The effect doesn’t stop at screening. Mucci said being married is also associated with better survival outcomes after a prostate cancer diagnosis, a pattern she attributes in part to the practical and emotional support a partner can provide throughout diagnosis and treatment. “Having that companionship has been really important for a range of health diseases,” she said, adding that while a similar effect exists for women and breast cancer, “the stronger association is for men and prostate cancer.”

Access to regular health care plays a role too. Mucci said socioeconomic factors, including education, income and insurance status, strongly predict whether men make it to a doctor’s office in the first place, let alone receive a screening recommendation once they’re there. “We do know people who have lower levels of education, less income, people who are not insured, they’re much less likely to get screened,” she said.

A Story That Illustrates the Stakes

Mucci shared an example that stuck with her: two close friends, both Ashkenazi Jewish, a population at higher risk for prostate cancer, who had lived remarkably similar lives. One began screening at 50 after his physician recommended it. The other wasn’t screened until symptoms appeared at 64, by which point he was diagnosed with more aggressive disease. “So there is a lot of misinformation, a lot of misunderstanding right now,” Mucci said, reflecting on how two people with nearly identical risk profiles and life circumstances ended up with very different outcomes based largely on when they started screening.

What Actually Moves the Needle

Asked what has been most effective in getting reluctant men to finally book an appointment, Mucci pointed to the power of relationships, both intimate partners and broader social networks. “Going back to the partners and having messaging that reaches not only the patient themselves, but the spouse as well ... I think that can be a big driver,” she said. She also highlighted the role of patient navigators and peer support, noting that men newly diagnosed with prostate cancer often become vocal advocates within their own circles. “Once they get diagnosed with cancer, they then say to every friend, every family member, go get screened,” she said.

Mucci also described simple, low-cost health system interventions that have meaningfully increased screening rates elsewhere, including direct outreach messages sent to patients once they become age-eligible, an approach she saw succeed with colleagues in North Carolina, as well as reminder postcards used for cervical and breast cancer screening in Sweden. “The more active follow-up of patients, you could see their screening rates are extremely high,” she said.

She also emphasized that a prostate cancer diagnosis carries implications beyond the individual patient, since family history strongly predicts prostate cancer risk in sons and brothers. “Knowing your own prostate cancer status is actually really helpful for your loved ones as well,” Mucci said.

Prevention Overlaps With Overall Health

Mucci closed by noting that many of the same lifestyle habits that reduce prostate cancer risk, particularly the risk of more aggressive disease, also support broader health. “There’s really good data now that eating a plant-forward, healthy diet also is beneficial for preventing prostate cancer. It’s good for heart disease, good for other cancers,” she said, along with not smoking, staying physically active and maintaining a healthy body weight. “It doesn’t mean you have to go run a marathon,” she added, “but getting out, walking with a friend” can make a meaningful difference.