The American Cancer Society on Thursday released updated guidance urging regular prostate cancer screening for middle-aged men, a shift away from the more hands-off approach the organization has recommended since 2010. The new guideline calls for PSA-based blood tests every two years for average-risk men ages 50 to 69, and annual testing starting at age 45 for Black men and men with a strong family history of the disease.
A Shift From Leaving The Decision To Patients
Since 2010, the American Cancer Society had recommended that average-risk men simply discuss regular PSA testing with their doctors, without pushing for routine screening, according to the organization's announcement carried by American Cancer Society. The group now says the updated advice reflects stronger evidence that screening with a PSA test significantly reduces prostate cancer mortality and diagnoses of advanced-stage disease, alongside a better understanding of how to limit the test's downsides. PSA itself is a protein produced by both normal and cancerous prostate cells, and the screening itself is a simple blood draw, per the same guideline.
The disease remains one of the most common cancers affecting men, and the stakes behind the update are significant: the American Cancer Society estimates that 333,830 men in the United States will be diagnosed with prostate cancer in 2026, with roughly 36,320 expected to die of it. The organization also says Black men face a 67% higher incidence rate and nearly double the mortality rate compared with White men, a disparity that helps explain why the new guideline recommends earlier and more frequent screening for that group, starting annual checks at age 45 rather than 50.
What Happens After An Elevated Result
Under the updated guidance, men ages 45 to 69 with PSA levels of 3.0 ng/mL or higher should get repeat testing between two weeks and three months later to confirm the result before moving forward, the American Cancer Society says. High PSA levels don't automatically mean cancer — they can also point to a benign enlarged prostate or even a temporary spike after vigorous exercise, according to reporting from WKMG, which cited Associated Press health writer Lauran Neergaard. Once an elevated PSA is confirmed, the guideline calls for offering MRI scans and/or a validated biomarker test to help decide whether a biopsy is actually needed, aiming to avoid unnecessary procedures.
That caution traces back to a problem the American Cancer Society has openly grappled with: widespread PSA testing in years past was blamed for overtreatment of slow-growing tumors that may never have caused harm, along with a wave of unnecessary follow-up tests in men who turned out not to have cancer. The new layers of confirmation testing and imaging are designed to catch dangerous cancers while reducing those false alarms.
Guidance Gets Murkier After 70
For men ages 70 to 74, the American Cancer Society recommends individualized decision-making about whether to continue screening, saying the balance of benefits and harms remains uncertain at that age — in practice, men starting at 70 are advised to discuss with their doctors whether continuing routine PSA checks still makes sense for them. The guideline's language on older men has also produced some inconsistency in how it has been reported: the American Cancer Society's own press materials state that screening is not recommended for men 80 and older or for men not expected to live another ten years because of other health problems, while a report from Urology Times describes the cutoff as age 75. Readers weighing screening decisions in that age range should check directly with the American Cancer Society's guideline for the precise threshold.
The American Cancer Society's approach also diverges from that of the U.S. Preventive Services Task Force, the influential federal panel whose current recommendation treats screening for men 55 to 69 as an individual choice to be made with a clinician, while recommending against PSA-based screening entirely for men 70 and older, according to the U.S. Preventive Services Task Force. That task force estimates screening may prevent roughly 1.3 prostate cancer deaths per 1,000 men screened over about 13 years, while cautioning that harms can include false-positive results requiring additional testing and biopsies, overdiagnosis, overtreatment, and treatment complications.
Supporting the case for earlier and more consistent screening, a 2025 study of men ages 55 to 69 found that prostate cancer deaths were 13% lower among those assigned to PSA screening compared with those who went unscreened, as reported by USA Today. STAT News notes that the update marks a clear departure from the American Cancer Society's 2010 guidance, which left testing decisions for average-risk men largely up to patient discretion rather than actively recommending it on a set schedule.
