The American Cancer Society now recommends routine PSA-based prostate cancer screening every two years for average-risk men aged 50 to 69, with earlier and more frequent screening for men at higher risk.
By Hermes Vector
The American Cancer Society (ACS) has updated its prostate cancer screening guideline for the first time since 2010, issuing a direct recommendation for routine screening rather than leaving the decision to shared decision-making between patients and doctors.
The ACS now recommends PSA-based screening every two years for average-risk men aged 50 to 69. For men at higher risk, including Black men and men with a strong family history of prostate cancer, the organization recommends annual PSA-based screening beginning at age 45. Non-Black men with a single first-degree relative diagnosed at age 65 or older should be screened every two years from ages 45 to 69.
For men aged 70 to 74, the guideline recommends individualized decision-making on continuing screening. Screening is not recommended for men aged 75 and older, though some men ages 75 to 79 who are very healthy may want to continue screening after discussing it with a healthcare provider. Screening is not recommended for men aged 80 and older, or for men not expected to live another ten years.
Men with elevated PSA levels—defined as 3.0 ng/mL or higher for men aged 45 to 69, and 6.5 ng/mL or higher for men aged 70 to 74—should undergo repeat PSA testing between two weeks and three months. Men with a confirmed elevated PSA should be offered testing by magnetic resonance imaging (MRI) and/or a validated biomarker to guide biopsy decisions. Men diagnosed with prostate cancer that has a low risk of growing or spreading should be offered active surveillance as the initial management option.
The ACS cited stronger evidence showing that PSA-based screening significantly reduces prostate cancer mortality and diagnosis of advanced-stage disease. The organization also noted advances in approaches to an elevated PSA that can reduce harms such as unnecessary biopsies and treatment.
"PSA testing remains the cornerstone of detecting prostate cancer early, and we now have stronger evidence of its benefits," said Dr. Robert Smith, senior vice president, early cancer detection science, and director, Center for Early Cancer Detection at the American Cancer Society and senior author of the report.
"By making a direct recommendation for men to engage in screening and advocating for earlier and more frequent screening for Black men, our aim is also to help reduce prostate cancer disparities and ease the disease burden," said Dr. William Dahut, chief scientific officer at the American Cancer Society and a contributing author of the study. "Black men experience a 67% higher incidence and nearly double the mortality rate compared with White men, an inequity that needs immediate reversal."
The guideline update is published in a report in CA: A Cancer Journal for Clinicians, the flagship journal of ACS. Prostate cancer is the second leading cause of cancer death in men in the United States. An estimated 333,830 men will be diagnosed with prostate cancer in 2026, with an estimated 36,320 men dying of the disease.
Sources
This article was drafted with AI assistance and checked against the sources above. Company claims are reported as claims. Cover image is AI-generated.
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The American Cancer Society now recommends PSA screening every two years for average-risk men ages 50 to 69, with annual screening starting at 45 for Black men and others at higher risk.
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