Germany continues to show a marked difference in life expectancy between men and women; the most recently published life tables and cause-of-death statistics confirm that men die earlier on average. According to the Federal Statistical Office, life expectancy at birth in 2025 was 79.1 years for men, compared with 83.6 years for women. At the same time, Prostate cancer and other cancers are among the most common causes of death in men. This situation has brought the debate over prostate screening back into focus.
Medical associations and institutions recommend an individualised approach to screening decisions. Germany’s statutory cancer screening programme provides for medical advice, a physical examination of the prostate and assessment of any symptoms for men aged 45 and over. In addition, recent reviews and meta-analyses, including updated analyses from the European Randomized Study of Screening for Prostate Cancer (ERSPC) and systematic reviews, indicate that regular PSA-test screening strategies can reduce prostate cancer-specific mortality in the cohorts studied over longer periods of follow-up, but also carry risks such as overdiagnosis and unnecessary treatment.
Against this background, the German Cancer Aid and urological medical associations recommend evidence-based information: the PSA test is not a universal screening requirement, but one factor to consider when weighing the benefits and drawbacks. Decision-making tools should take account of age, comorbidities, personal preferences and individual cancer risk. For men at increased risk – for example, because of a family history or particular genetic findings – there is a strong case for more intensive early detection and closer follow-up.
Public health bodies such as the Robert Koch Institute and the Federal Statistical Office also highlight the importance of socioeconomic factors: differences in education, income and regional access to healthcare influence health behaviour and access to early-detection services, and contribute to the life expectancy gap.
The implications for health policy are clear: expanding accessible, quality-assured advice, providing clear guidance on communicating the benefits and risks of PSA testing, and targeted programmes for at-risk groups can help reduce preventable deaths without encouraging unnecessary overtreatment. Fact-based communication and better continuity of care remain key levers for sustainably reducing male mortality .
Editor: Phillipe Schmidt-Araguin (Article created with AI assistance).