General Discussion

Guidelines are not absolutes. Although many health non-care organizations and denial-of-coverage insurance companies like to pretend that they are and so will refuse to cover something that's not clearly within the guidelines.

In the case of insurance companies, they often initially deny guideline directed testing as well. Saves them money, especially as they hope you might die in the meantime. I base this on over a half century of medical practice as a physician as well as from these past few years of being a patient.

The current guidelines (2023) from the American Urological Association state, in part https://www.auanet.org/guidelines-and-quality/guidelines/early-detection-of-prostate-cancer-guidelines
The US Preventive Services Task Force was more directive (back in 2018) and bluntly states https://www.auanet.org/guidelines-and-quality/guidelines/early-detection-of-prostate-cancer-guidelines

My own prostate cancer was diagnosed in my seventies on the basis of an elevated PSA ordered by my primary care NP. If this had not been done, it would have been found on the annual PSA my urologist would have ordered. Before the elevated one, my PSA had been stable at the upper limit of starting to worry. The last had been done 4 months prior to the one ordered by my NP.

In my own experience I know of NO urologist or PCP who follows the "do not draw PSA on men (or women) over 70" guidelines. If PSA is normal-normal it might be done every other year (or even three) but it will be done at least every 3-4 years if you're over fifty.

As mine was high-normal, both my NP and Urologist checked it annually as they practice in different healthcare settings and each wanted the results in their medical records.

Neither you (in the general sense), nor I and likely none of the talking-heads knows (or has any right to know) the specifics of why the diagnosis was not made until it was.

Joe Biden is no longer the President. He's an oldie with a dreadful disease. Leave him TF in Peace.