Prostate cancer is one of the most common malignancies of the male genitourinary system. Epidemiological studies have shown that the occurrence of prostate cancer is mainly related to factors such as age, race, family genetic background, geographic location and dietary structure. The incidence of prostate cancer varies widely worldwide, with the incidence rate in Asians being much lower than that in Europe and the United States. In the United States, the incidence of prostate cancer ranks first among all malignant tumors in men, and the mortality rate ranks second only to lung cancer. At present, China has entered an aging society, and with the increase of life expectancy, change of diet structure and improvement of tumor screening and diagnosis, the incidence rate of prostate cancer in China is much lower than that of western developed countries, but it has been on the rise in recent years and is now the 3rd malignant tumor of male genitourinary system, which has gradually become one of the important tumors that seriously affect the life and health of men in China. Unlike other common malignant tumors of the urinary system, prostate cancer does not have typical clinical symptoms because it occurs mostly in the peripheral zone of the prostate gland, and early prostate cancer is mostly confined to the prostate gland without invading the surrounding tissues of the prostate gland. However, as the tumor progresses, it will show many different clinical symptoms: 1. Lower urinary tract symptoms, including irritation and obstruction symptoms. First of all, it should be clear that lower urinary tract symptoms are not unique to prostate cancer, but are more often seen in many benign urological lesions. In patients with prostate cancer, lower urinary tract symptoms can be caused when the tumor infiltrates into the anterior middle of the prostate and invades the urethra, bladder neck and triangle. The symptoms include frequent urination, urgent urination, hesitant urination, interruption of urination, dribbling after urination and straining to urinate, etc. Local infiltrative symptoms: The growth and development of prostate cancer tend to develop along the weakest pathway. Most prostate cancers originate in the peripheral zone of the prostate, that is, in the posterior part of the prostate, so the cysto-rectal space is often the first area invaded by local infiltrative prostate cancer. If the tumor invades the prostate envelope and its adjacent perineural lymphatics, it may cause perineal pain and sciatica; if the tumor invades the vas deferens, it may cause low back pain and testicular pain; if the tumor invades the upper part of the cysto-rectal space, it may compress the ureter and cause unilateral or bilateral hydronephrosis, which may lead to renal failure. If the tumor invades the neurovascular bundle on the back side of the prostate, it will lead to erectile dysfunction. Metastatic symptoms: The most common metastatic site of prostate cancer is bone, sometimes it may also metastasize to other organs, such as lung, liver and adrenal gland. Bone metastasis of prostate cancer may cause bone pain and even pathological fracture; tumor metastasis to pelvic lymph nodes may cause lower limb edema; tumor metastasis to lung may cause coughing and coughing blood, etc. 4. Systemic symptoms: late stage prostate cancer may manifest as wasting and weakness, low fever, progressive anemia, cachexia or renal failure. It can be seen that the early symptoms of prostate cancer patients are atypical and cannot be detected through early clinical manifestations, while prostate cancer is often at an advanced stage when certain clinical symptoms appear. Since the key to improving the treatment effect of prostate cancer is early diagnosis and early treatment, prostate cancer screening is especially important for the treatment effect of the disease. Screening for prostate cancer refers to the application of simple and effective screening methods to detect the tumor early before the patient develops the related symptoms. The common screening methods include DRE, PSA, TRUS, MRI and TRUS-guided transrectal prostate puncture biopsy, among which DRE and PSA are the most common and basic screening methods. In some developed countries in Europe and America, prostate cancer screening programs are more aggressive due to the high incidence of prostate cancer. For example, the American Urological Association (AUA) and the American Society of Clinical Oncology (ASCO) recommend that men over the age of 50 should receive routine DRE and PSA examinations every year, and for men with a family history of prostate cancer should start at the age of 45. The Guidelines for the Diagnosis and Treatment of Prostate Cancer developed in China recommend that men over the age of 50 with lower urinary tract symptoms should routinely undergo PSA and DRE, and men with a family history of prostate cancer should begin these tests at age 45. However, in recent years, as the understanding of prostate cancer has improved, some scholars have also raised the issue of overtreatment, arguing that such extensive screening does not improve the overall survival of patients with prostate cancer. The jury is still out on this issue. However, the general principle is that screening should be preceded by full communication with the patient about the pros and cons of screening and making the final decision. Rectal examination is one of the most economical and basic tests for prostate cancer screening. About 15% to 40% of prostate cancer patients can have abnormalities detected during rectal examination, but the diagnostic accuracy is low and closely related to the clinical experience of the physician. In addition, most of the prostate cancers detected by rectal examination are intermediate and advanced prostate cancers, and the combination with PSA can significantly improve the diagnostic rate. PSA is a single chain glycoprotein with serine protease activity in prostate tissue. When the prostate tissue is cancerous, a large amount of PSA enters the body’s blood circulation after the normal tissue is destroyed, causing the PSA in the blood to rise. There are many factors that affect PSA levels, such as prostatitis, prostate enlargement and acute urinary retention, prostate biopsy, cystoscopy, rectal examination, ejaculation, transurethral surgery, etc., which can increase serum PSA levels; and some drugs, such as finasteride, which can lower serum PSA levels. In other words, PSA is a prostate tissue-specific antigen, not specific to prostate cancer, and the above-mentioned influencing factors should be considered when testing PSA. The PSA test should be performed 24 hours after ejaculation; 48 hours after rectal examination, cystoscopy, catheterization and other operations; 1 week after prostate massage; 1 month after prostate puncture; the test should be free of acute prostatitis, urinary retention and other diseases, so that the PSA test results are more accurate and credible, and have more clinical significance and value. Other screening methods, such as transrectal ultrasound (TRUS) examination, prostate MRI examination, TRUS-guided transrectal prostate puncture biopsy, etc., are often performed when abnormalities are found on rectal finger examination or PSA examination, and further tests are performed to clarify the diagnosis. As the life expectancy of our population has increased and the standard of living has improved, prostate cancer has become one of the most common malignant tumors of the male genitourinary system in China, and early detection and early treatment is the key to cure prostate cancer. The majority of people should raise their awareness of cancer prevention and fight against cancer, not only can they not talk about cancer and worry about it, but also cannot be sloppy and careless and miss the disease. Apply scientific means to stay away from tumors and overcome them!