Former President Joe Biden’s diagnosis of an aggressive, stage-4 prostate cancer has reignited a long-simmering medical debate: When should men get screened for prostate cancer? For decades, doctors have wrestled with how often to screen men for the disease and when to start and stop.

In Biden’s case, doctors say the cancer is serious but still treatable, though not curable. President Donald Trump, 78, had a PSA test earlier this year, according to medical records that have been made public — meaning some doctors are still choosing to screen older patients for prostate cancer.