The American Cancer Society released updated prostate cancer screening guidelines Thursday, recommending specific testing intervals for men instead of leaving decisions entirely to individual doctor consultations. The organization now advises men at average risk to begin prostate-specific antigen blood testing every two years between ages 50 and 69.
Who Should Get Tested and When
Men facing higher risk factors should begin screening earlier, according to the new guidelines. Black men and those with strong family histories of prostate cancer should start PSA testing at age 45. The recommendations acknowledge research showing Black men have higher development rates of prostate cancer and face more than double the mortality risk compared to other men, according to the Centers for Disease Control and Prevention.
Men between 70 and 74 should discuss testing benefits and drawbacks with their physicians, while those 75 and older or with life expectancies under 10 years should discontinue screening. Men showing elevated PSA results can explore additional MRI testing options with their doctors. The guidelines also specify that men with PSA levels at 3.0 or higher should receive annual screenings, while those at 2.5 or lower should test every two years.
Evidence Supporting the Changes
Dr. William Dahut, the American Cancer Society’s chief scientific officer and medical oncologist, explained the update addresses new evidence demonstrating PSA testing can reduce prostate cancer mortality. Prostate cancer ranks among the most common cancers affecting American men, with more than 266,000 new cases reported in 2023 and over 34,000 deaths in 2024, according to CDC data. The cancer develops when prostate cells grow uncontrollably.
Disagreement Among Medical Organizations
Medical groups maintain varying positions on prostate cancer screening. The CDC and U.S. Preventive Services Task Force avoid recommending PSA testing at specific ages, instead encouraging men to discuss individual risks and benefits with physicians. The American Academy of Family Physicians does not recommend PSA screening at all. The American College of Physicians suggests men between 50 and 69 with life expectancies exceeding 10 to 15 years discuss screening options, while the American Urological Association recommends testing for men 55 to 69 with similar life expectancies, though high-risk individuals should start at 40.
PSA testing carries potential downsides including overdiagnosis, false positives, and overtreatment. The CDC notes screenings may not extend lifespans since prostate cancers typically grow slowly. Some treatments produce adverse effects including urinary incontinence, erectile dysfunction, and bowel problems. Many physicians follow American Cancer Society guidelines, though official adoption of these changes will likely require years to fully implement across medical practices nationwide.