Middle-aged men should get regular prostate cancer screenings, the American Cancer Society said Thursday, a major shift from its earlier guidance. The group now recommends a simple PSA blood test every two years for men at average risk between ages 50 and 69.
Men at high risk, including Black men and those with a strong family history of the disease, should be tested yearly and start at age 45. A family history of one close relative diagnosed before 65, or several relatives diagnosed at any age, places a man in the high-risk group. Men with only one relative diagnosed after 65 should still begin at 45 but can test every two years.
Since 2010, the society had told average-risk men to discuss PSA testing with their doctors. Routine testing was blamed in the past for overtreatment of slow-growing tumors. The new guidance points to steps that reduce those harms, such as repeating a high result, adding an MRI before a biopsy and monitoring low-risk tumors instead of treating them right away.
The guidance still calls for a conversation with a doctor about benefits and risks. Men should discuss screening at 70, and the society no longer recommends it at 75 or later. It also discourages screening after 80. Men who are not expected to live another 10 years should not be screened.
The society estimates more than 333,000 U.S. men will be diagnosed with prostate cancer in 2026 and about 36,000 will die of it.
The update takes effect nationally and is aimed in part at primary care doctors, who often introduce screening to patients.
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