In a significant shift, the American Cancer Society announced Thursday that men at average risk for prostate cancer should undergo a prostate‑specific antigen (PSA) blood test every two years between ages 50 and 69. The update aims to simplify screening recommendations and reduce confusion for patients and primary‑care providers.
Who should be screened and how often
Men considered at average risk – those without a strong family history and who are not Black – are now advised to start biennial PSA testing at age 50. Men identified as high‑risk, including Black men and those with a close family member diagnosed with prostate cancer before age 65, should begin annual PSA checks at age 45.
Why the change
Since 2010, the Society suggested that men discuss the benefits and drawbacks of PSA testing with their doctors, leaving the timing and frequency to individual decision‑making. Recent research has clarified how regular PSA screening can catch aggressive cancers early while new protocols help avoid overtreatment of slow‑growing tumors.
Key improvements include confirming elevated PSA results with a repeat test, using magnetic resonance imaging (MRI) to better identify which patients need a biopsy, and adopting active‑surveillance strategies for low‑risk cancers rather than immediate aggressive treatment.
Expert perspective
Dr. Ash Tewari, head of the urology department at Mount Sinai’s Icahn School of Medicine, praised the new guidance, saying, “This has taken ambiguity out of it. They are basically saying, ‘Do it.’ This guideline will only make things easier for men, and hopefully it will have more grandfathers eating dinner with their families ten years from now.”
Dr. Tewari emphasized that the recommendation is not a one‑size‑fits‑all mandate. “We want to find the right balance,” he said. “Patients need to understand that their risk of prostate cancer differs.”
Defining high‑risk family history
The Society defines a strong family history as having a father, brother, or son diagnosed with prostate cancer before age 65, or multiple close relatives diagnosed at any age. Men with this background should start annual PSA testing at 45. If a single close relative was diagnosed after age 65, screening can begin at 45 but may be spaced every two years.
When to stop screening
The updated guidance advises men to discuss the continuation of testing with their physician around age 70, as benefits become less clear. Routine screening is no longer recommended after age 75, though healthy men aged 75‑79 may choose to continue. Screening is discouraged once a man reaches 80.
Impact on public health
Prostate cancer remains one of the most common cancers among men in the United States. The Society estimates that more than 333,000 men will receive a diagnosis in 2026, with approximately 36,000 deaths. Early detection through appropriate screening can improve survival rates while minimizing unnecessary procedures.
Patients are encouraged to have an open conversation with their healthcare provider about personal risk factors, the potential benefits of early detection, and the possible harms of over‑diagnosis. By following the updated guidelines, men can make informed decisions that protect both their health and their families.
Original reporting: 40/29 / KHBS (NW Arkansas) — read the source article.
