Against the backdrop of China's escalating population aging, the incidence of prostate cancer is rising significantly, leading to an increasing disease burden. Prostate-specific antigen (PSA) screening is currently an effective method for improving early diagnosis rates and patient prognosis. However, there is a lack of large-scale, prospective studies in China to guide the development of screening strategies. This article analyzes the impact of population aging on healthcare economics, describes the current status and trends of the prostate cancer disease burden, and combines the latest evidence on PSA screening from both domestic and international sources to conduct an in-depth discussion on the necessity, and existing models of PSA screening in China. It also emphasizes that when developing screening strategies, the disease burden brought about by aging and health economic benefits must be fully considered. This article aims to provide a reference for the development of an individualized prostate cancer screening program that aligns with China's national conditions and considers cost-effectiveness, thereby helping to improve the overall diagnosis and treatment level of prostate cancer in China and improve patient survival and quality of life.