American Cancer Society Recommends Routine PSA Screening for Men

The American Cancer Society has updated its prostate cancer screening guidelines, recommending routine PSA testing for most men for the first time since 2010.

New Screening Recommendations

Men at average risk should get a PSA test every two years from age 50 to 69, according to the new guidelines released Thursday.

Men at higher risk should start testing at age 45. Yearly testing starting at 45 is recommended for all Black men, who have higher rates of prostate cancer. Non-Black men should also get yearly testing starting at 45 if a close relative was diagnosed with prostate cancer before age 65, or if more than one of their relatives has had prostate cancer. If only one close relative was diagnosed at age 65 or older, non-Black men should start at 45 but are recommended to get testing every two years.

Men ages 70 to 74 should consult their doctor on continuing screening, while those 75 and up are not recommended to get screened.

Follow-Up Steps

The ACS advises all men to be informed about the risks and benefits of screening. If a PSA test comes back high—defined as 3 ng/mL or higher for men under 70 and 6.5 ng/mL or higher for those 70 and up—the ACS recommends repeating the test before taking any next steps.

If repeat testing is still high, men should get either a prostate MRI or a validated biomarker test to assess risk. Only if there is a high suspicion of cancer should men proceed to a prostate biopsy.

For men diagnosed with prostate cancer, active surveillance should be the initial management strategy for men whose cancer appears to be at low risk of growing or spreading.

Why the Change

The ACS says its updates are based on new evidence since 2010 that shows screening saves lives, and that advances in case management can avoid the concerning harms from overdiagnosis and overtreatment.

"By catching aggressive cancers with a simple PSA blood test, you open the door to highly effective treatments that protect your future," Dr. Shanthi Sivendran, interim chief patient officer for the ACS, said in a statement. "Meanwhile, lower-risk findings can be safely managed through careful, active surveillance."

Prostate cancer is one of the most common cancers in men and the second leading cause of cancer death in US men, the ACS notes. Nearly 334,00 men are estimated to be diagnosed with prostate cancer in 2026, and it’s estimated that over 36,320 will die from the disease.

Why it matters

The new guidance departs from ACS’s previous iteration, published in 2010, which made no universal recommendations for routine screening. Men at age 50 were recommended to use shared-decision making with their doctors on whether or not to get tested. The recommendation was similar to that from the US Preventive Services Task Force, a federal panel that regularly evaluates evidence and makes recommendations on such preventive medical care.

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Sources

• arstechnica.com: In reversal, American Cancer Society urges prostate cancer tests for all men - Ars Technica
• newscord.org: American Cancer Society Updates Prostate Cancer Screening With Regular PSA Testing: 14 outlets compared | NewsCord
• theroot.com: Black Men Urged to Start Prostate Cancer Screening at 45
• aroundprague.cz: American Cancer Society Urges PSA Tests Every Two Years From Age 50
• mezha.net: American Cancer Society urges regular prostate cancer screening for men

This article was drafted with AI assistance and checked against the sources above. Company claims are reported as claims. Cover image is AI-generated.