The American Cancer Society (ACS) released updated prostate cancer screening guidelines on Thursday, offering clearer recommendations for men across the United States. The new guidance emphasizes regular prostate‑specific antigen (PSA) blood testing for men at average risk and earlier testing for those with higher risk factors.
Key Recommendations
Men with average risk of developing prostate cancer should begin PSA testing at age 50 and repeat the test every two years until age 69. For men identified as higher risk—such as Black men or those with a strong family history of the disease—the ACS advises starting screening at age 45.
Men aged 70‑74 are encouraged to discuss the benefits and drawbacks of continued testing with their physicians, while those 75 and older, or those not expected to live another ten years, should discontinue routine PSA screening.
Rationale Behind the Update
“We thought it was really important to update our prostate cancer guidelines, because now there is true evidence that prostate cancer screening with the PSA test, a blood test, can actually decrease one’s chance of dying from prostate cancer,” said Dr. William Dahut, ACS chief scientific officer and medical oncologist, in an interview released by the organization.
The ACS points to research showing that Black men face a higher incidence of prostate cancer and are more than twice as likely to die from the disease compared with other men, according to the U.S. Centers for Disease Control and Prevention (CDC). By encouraging earlier and more consistent screening for this group, the ACS hopes to address that disparity.
Screening Frequency Based on PSA Levels
The updated guidelines also refine testing intervals based on PSA results. Men with a PSA level of 3.0 ng/mL or higher should be screened annually, while those with a PSA of 2.5 ng/mL or lower may continue with biennial testing.
How the ACS Guidance Compares to Other Organizations
Screening recommendations vary among major medical bodies. The CDC and the U.S. Preventive Services Task Force (USPSTF) do not set a specific age for PSA testing, leaving the decision to individual men and their doctors, though they advise against routine screening for men 70 and older. The American Academy of Family Physicians does not recommend PSA screening at all.
The American College of Physicians suggests men discuss benefits and risks with their physicians and recommends screening for those aged 50‑69 who have a life expectancy of more than 10‑15 years. The American Urological Association advises screening for men 55‑69 with a similar life‑expectancy threshold, but recommends that higher‑risk men begin at age 40.
Potential Risks and Benefits
While the ACS emphasizes that PSA screening can lower mortality, it also acknowledges potential downsides. Overdiagnosis, false‑positive results, and overtreatment are noted concerns. Some treatments may lead to urinary incontinence, erectile dysfunction, or bowel problems, and not all detected cancers progress quickly enough to affect lifespan.
Despite these risks, the ACS argues that informed, shared decision‑making between patients and physicians can help balance the benefits of early detection with the possibility of unnecessary interventions.
Looking Ahead
Official adoption of the ACS recommendations by other medical societies may take years, but many physicians already follow ACS guidance in clinical practice. The organization encourages men to have open conversations with their healthcare providers to determine the best screening schedule based on individual risk factors and overall health.
Original reporting: Allentown News – 6abc Philadelphia — read the source article.
