Prostate cancer screening is controversial, and major professional associations offer differing screening guidelines. The authors address 3 key issues about prostate cancer screening: 1) the prostate-specific antigen (PSA) criteria to recommend a prostate biopsy, 2) the appropriate age to start screening, and 3) the appropriate age to stop screening. The authors argue, on the basis of evidence published since 2000, that data supporting the efficacy of PSA screening are convincing. They recommend screening for risk assessment for average-risk men beginning at age 40 years, screening selected healthy men older than age 70 years, and lowering the PSA threshold for considering biopsy to 2.5 ng/mL for all men.