Former President Joe Biden had not been screened for prostate cancer in the last decade before discovering an aggressive form of the disease last week, according to Biden’s office.

“President Biden’s last known PSA (Prostate Specific Antigen test) was in 2014,” a Biden spokeswoman told the Washington Examiner on Tuesday. “Prior to Friday, President Biden had never been diagnosed with prostate cancer.”

Biden’s cancer screening history came under scrutiny this week when he announced on Sunday that he had Stage 4 prostate cancer, with some critics, including President Donald Trump and Vice President JD Vance, asking whether he had been diagnosed earlier but did not want to disclose the change in his health status.

“I’m surprised that the public wasn’t notified a long time ago, because to get to stage 9, that’s a long time,” Trump said earlier Tuesday, misidentifying Biden’s cancer. “I did a very complete physical, including cognitive tests. I’m proud to announce I aced it.”

A former White House aide told the Washington Examiner this week that a “lack of disclosure” from the Bidens “would not surprise me.”

“It was like pulling teeth to get them to be transparent about anything … like the small stuff, that I always wondered what would happen if there was big stuff,” the aide said.

Regardless, Biden’s longtime White House physician, Dr. Kevin O’Connor, in particular, has been criticized for not screening the president for cancer, though regular testing for prostate cancer among men older than 70 is no longer recommended. Biden would have been 72 in 2014.

In Biden’s initial statement, the former president shared that his cancer had metastasized to the bone and was only discovered last week after a “small nodule” was found in his prostate following a complaint about urinary symptoms.

“While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive, which allows for effective management,” a Biden spokesman told the Washington Examiner at the time.

White House press secretary Karoline Leavitt on Monday was pushed on whether Trump had undergone a cancer screening last month during his annual physical. Leavitt told reporters during a briefing that the president had “to the best of my understanding,” but deferred to Trump.

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“I’ll let the president speak on that,” she said. “I spoke to the president again about the former president’s health diagnosis last night, and he wanted to extend his warmest wishes to the former president and his family. But as for any further action, I’ll let the president speak on that.”

Biden’s cancer diagnosis coincides with the release of Original Sin, a book by Jake Tapper and Alex Thompson, which reports on Biden’s decision to run again despite widespread concerns about his health and mental acuity.