The American Cancer Society has, for the first time, recommended routine prostate cancer screening for men, ending more than a decade in which it stopped short of advising regular testing. The updated guidance, published on Thursday in CA: A Cancer Journal for Clinicians, calls for PSA blood tests every two years for men at average risk aged 50 to 69.
Men at higher risk — Black men and those with a close family history of the disease — should be screened every year from the age of 45. The society said the change reflected stronger long-term evidence that screening reduces deaths from prostate cancer, alongside newer ways of limiting the harms of testing.
The previous guidance, issued in 2010, asked men to decide whether to be tested only after discussing the advantages and disadvantages with a doctor. That cautious approach reflected a difficult trade-off: PSA tests can detect tumours before they spread, but most prostate cancers grow slowly and many would never cause harm. Unnecessary biopsies and treatment can bring serious side effects, including sexual dysfunction and urinary incontinence.
The new guidance aims to reduce that overtreatment. A raised PSA result should now be confirmed with a repeat blood test, followed by MRI imaging or additional blood tests before any biopsy is scheduled. The society also lowered the threshold for further investigation to 3.0 nanograms per millilitre, from the 4.0 level long used by most US laboratories.
The change matters most for the groups at greatest risk. Black men face a 67 per cent higher incidence of prostate cancer than white men and nearly double the mortality rate, according to the society. An estimated 333,830 American men will be diagnosed with the disease in 2026 and 36,320 will die of it, making it the most commonly diagnosed cancer among US men and the second leading cause of cancer death in men.
The guidance does not recommend routine screening for men aged 75 and older, although very healthy men aged 75 to 79 with rising PSA levels may choose to continue. Screening is not advised for men aged 80 and over, or for those with a life expectancy of less than 10 years. Men aged 70 to 74 should discuss the decision with their doctor, as the balance of benefits and harms remains uncertain for that group.
The shift does not automatically change what insurers must cover. The US Preventive Services Task Force, whose recommendations carry legal weight for insurance coverage, still advises individual decision-making for men aged 55 to 69 and recommends against screening from 70. The task force is reviewing its own guidance, with no release date announced.
Sources: Reuters (https://mymixfm.com/2026/11/12/american-cancer-society-calls-for-routine-prostate-cancer-screening-in-guideline-change/); NPR (https://www.khsu.org/2026-11-12/american-cancer-society-updates-prostate-cancer-screening-guidelines); Urology Times (https://www.urologytimes.com/view/american-cancer-society-updates-prostate-cancer-screening-guidelines-recommends-regular-psa-testing)
