Key takeaways

• Prostate cancer is considered an aging-related disease, but it is becoming more prevalent in younger men.
• Prostate cancer in younger men may be more aggressive, and survival rates are lower, possibly due to inherited gene mutations.
• Lower survival may also be due to late detection (absence of symptoms, misdiagnosis of symptoms, waiting too long to see a doctor, lack of screening).
• It’s important to raise awareness that prostate cancer can strike younger men.
• Screening should not be avoided because MRI can clarify a suspicious result before biopsy.
• Healthy lifestyle choices offer preventive value against prostate cancer.

Introduction

Prostate cancer is the most common non-skin cancer in men. Statistics reveal that the global burden of prostate cancer continues to grow. In 2022, there were about 1.47 million new cases worldwide, now projected to reach 2.4 million new cases annually by 2040.

Of special concern, there’s been an increase in early onset prostate cancer in men between 15 and 40 years old. The exact causes aren’t known, but a 2023 medical news summary points to risk factors, diagnostic improvements, more frequent screenings, and consciousness raising about the disease.

At what age is prostate cancer usually diagnosed?

Prostate cancer is a disease generally associated with growing older. According to the American Cancer Society, “About 6 in 10 prostate cancers are diagnosed in men who are 65 or older, and it is rare in men under 40. The average age of men when they are first diagnosed is about 67.”

In fact, along with family history of prostate or breast cancer, aging is a key risk factor for prostate cancer. Approximately 1 out of 8 men will be diagnosed with prostate cancer during their lifetime, primarily linked with older age, but as it strikes younger men, researchers are seeking answers.

Does prostate cancer strike younger men?

Yes, it is possible for younger men to develop prostate cancer, though statistically it is much less likely. That said, it’s important to clarify what is meant by “younger.” As Chambers, et al. wrote over 10 years ago, “being young as it applies to prostate cancer is not yet clearly defined.”^[i]

Many studies broadly refer to prostate cancer patients below age 50 as “younger men” based on the low prevalence of the disease in men under 50. However, a noteworthy analysis by Bleyer, et al. (2020) tells us that “prostate cancer has increased in older adolescents and young adults (AYAs) (defined as ages 15-39 years, inclusive) to a level that merits evaluation.”^[ii]

So yes, statistics show an increasing incidence of prostate cancer striking younger men.

Does prostate cancer behave in younger men the same as in older men?

Yes, prostate cancer seems to follow a different course in younger men. Younger men have worse survival rates than older men, though survival has been improving across the board since 2015 due to better treatments and better screening.

Still, the contrast is undeniable. The table below shows the difference in 5-year survival for U.S. men diagnosed between 2000-2015.^[iii]

Age at diagnosis	Relative survival rate at 5 years
15-24 years	30%
25-34 years	80%
40-80 years	95-100%

It is unclear if the disease truly behaves differently in young men. This could partly be due to inherited gene mutations, but the data collected prior to 2015 did not include genomic testing which has only become widely available more recently (and still is under-utilized in diagnosis). It’s possible that many young men carry a gene mutation such as BRCA1 or BRCA2 which brings a greater risk of developing prostate cancer early, and of more aggressive disease.

One thing is statistically clear, however. By the time a young man is diagnosed, it is probable that his cancer has already progressed to a later stage.

Why is prostate cancer caught at a later stage in younger men?

Part of the problem is the nature of the disease itself. Early-stage prostate cancer has virtually no symptoms. The Mayo Clinic identifies the earliest symptoms as

• Blood in the urine, which might make the urine look pink, red or cola-colored.
• Blood in the semen.
• Needing to urinate more often.
• Trouble getting started when trying to urinate.
• Waking up to urinate more often at night.

Later symptoms indicative of more advanced disease as it spreads beyond the gland may include back pain, bone pain, feeling very tired, unexplained loss of weight.

Sadly, men tend to overlook or deny symptoms, and therefore avoid seeing a doctor. When they finally consult a doctor, the doctor may not initially suspect prostate cancer in a younger man. Not only is it more expected with aging, but the early symptoms above are identical with infection or inflammation.

Finally, men younger than 40 do not get PSA screening tests. Even then, screening is usually limited only to those with the highest known risk factors. The American Cancer Society recommends

• Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years
• Age 45 for men at high risk of developing prostate cancer. This includes African American men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65).
• Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age)

As is evident, men under age 40 are not recommended to get annual PSA tests.

What are the most common theories about the rise in early onset prostate cancer?

In addition to known risk factors (primarily family history and racial/ethnic factors), here are the most common hypotheses regarding the increase in early onset prostate cancer:

• More PSA screening – Following the 2012 downgrading of the PSA test due to potential harms (over-biopsy, over-treatment), it was soon found that there were fewer diagnoses of low-risk prostate cancer but more diagnoses of high-risk cancer, so the pendulum has swung back to encourage annual testing. In particular, Black men have more cases of early onset disease, including at early age, so PSA screening is encouraged for younger Black men.
• As mentioned earlier, we now know that genomics is an important factor. Young men who carry certain gene mutations are at higher risk of developing prostate cancer early, and of the disease being potentially more lethal.
• Unhealthy lifestyle – we know more than ever about cancer-causing habits/conditions, particularly unhealthy diet, lack of exercise, alcohol, smoking, obesity, metabolic syndrome, and exposure to toxins. Many, but not all, of these problems may be correlated with demographic and socioeconomic situations. However, efforts are ongoing to raise awareness of the cancer-preventing value of healthy lifestyle choices.

What does the Sperling Prostate Center say?

Dr. Dan Sperling and his clinical team at the Sperling Prostate Center support raising awareness of prostate cancer in younger men. Our blogs contain consistent reassurance that an annual PSA test is no longer to be feared, since a suspicious result can be clarified by multiparametric MRI before biopsy.

Most importantly, early detection through the blood test and imaging saves lives and lifestyles. It is heartbreaking to think of men who don’t monitor prostate activity using this quick, inexpensive detection service. Detecting early, low-risk prostate cancer means it can be either safely monitored, or treated with a focal therapy to destroy the cancer while preserving urinary and sexual function.

Young men should discuss with their doctors any concerns they have about risk factors or unusual urinary or sexual symptoms.

Frequently asked questions (FAQ)

Q: When does a PSA test result mean cancer?

A: First, it’s important to know that the PSA test is not specific just for prostate cancer. It is a sign of increased activity in the prostate gland. It could mean infection, inflammation, sexual activity, certain physical stimulation, or prostate cancer. So, a suspiciously high number does NOT automatically mean prostate cancer. Second, PSA tends to increase as the prostate gland enlarges with age. See normal age ranges here.

Q: How does an MRI clarify an abnormal PSA test result?

A: Multiparametric MRI (mpMRI) excels at revealing any area suspicious for clinically significant prostate cancer. If a PSA test comes back with an abnormally high (or rising) number, it is important not to rush into a biopsy. Instead, mpMRI can determine if a biopsy is necessary by visually showing what’s going on. If a suspicious area is seen, a real-time MRI can guide biopsy needles, targeting a minimum number of them into the site most likely to contain aggressive cancer cells. On the other hand, if the MRI does not show significant prostate cancer, it is safe to hold off on a biopsy.

Content reviewed by Dr. Dan Sperling, M.D., DABR — updated June 2026

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

References

[i] Chambers SK, Lowe A, Hyde MK, Zajdlewicz L, Gardiner RA, Sandoe D, Dunn J. Defining young in the context of prostate cancer. Am J Mens Health. 2015 Mar;9(2):103-14.
[ii] Bleyer A, Spreafico F, Barr R. Prostate cancer in young men: An emerging young adult and older adolescent challenge. Cancer. 2020 Jan 1;126(1):46-57.
[iii] Bleyer, ibid.