The American Cancer Society issued its first major update to prostate cancer screening guidelines in more than a decade on Thursday, recommending routine blood testing for middle-aged men. Men at average risk should receive a prostate-specific antigen (PSA) blood test every two years between ages 50 and 69. Those at higher risk—including Black men and men with a strong family history—are advised to begin annual PSA screening at age 45.
The American Cancer Society projects 333,830 US men will be diagnosed with prostate cancer in 2026 and 36,320 will die from the disease. Since 2010, the organization had advised average-risk men simply to discuss testing pros and cons with doctors, amid concerns that widespread PSA checks led to unnecessary biopsies and overtreatment of slow-growing tumors. Health experts noted that repeating elevated PSA tests, adding MRI scans before ordering biopsies, and actively monitoring low-risk tumors instead of operating immediately have substantially reduced screening harms over the past decade.
Dr. Ash Tewari, chair of urology at Mount Sinai's Icahn School of Medicine in New York, told the Associated Press: This has taken ambiguity out of it. Men with one father, brother, or son diagnosed before age 65, or multiple close relatives diagnosed at any age, qualify for annual screening starting at 45, whereas those with one relative diagnosed after 65 can start at 45 on a two-year cycle. Screening is not advised for men with less than a 10-year life expectancy, and men are encouraged to review ongoing testing with physicians at age 70. Routine screening is no longer recommended at age 75—though healthy men aged 75 to 79 may choose to continue after consulting a doctor—and is discouraged altogether at 80 because treatment harms often outweigh benefits.
