New guideline urges routine prostate cancer screening for middle-aged men

Middle-aged men should undergo regular screening for prostate cancer, the American Cancer Society said Thursday in a major change to its guidelines.

The screening involves a simple blood test, and men at average risk of getting prostate cancer should get that PSA test every two years between the ages of 50 and 69, the cancer society advised.

Men at high risk, including Black men and those with a strong family history of prostate cancer, should get yearly PSA checks and start earlier, at age 45.

Thursday’s guideline update marks a shift in thinking about routine blood tests for PSA, or prostate-specific antigen.

Since 2010, the cancer society has recommended that men at average risk talk with their doctors about whether to get regular PSA tests. That’s a protein produced by both normal and cancerous prostate cells, meaning a high level might signal a tumor but also could be from a benign enlarged prostate or be a temporary spike from vigorous exercise.

Widespread PSA testing in the past was blamed for overtreatment of slow-growing tumors and unnecessary follow-up testing in men who turned out to not have cancer.

The updated advice comes after advances in understanding PSA's benefits and how to reduce potential harms, according to the cancer society. That includes steps such as repeating a PSA test to be sure it’s really high or adding an MRI scan to help identify who needs a biopsy.

How long should men continue screening? Starting at 70, men should talk with their doctors about whether it’s beneficial to continue the routine PSA checks, the guideline says. But it discourages screening for men 80 and older and those of any age who aren’t expected to live another 10 years because of other health problems.

Prostate cancer is one of the most common cancers in men. The cancer society estimates more than 333,000 men in the U.S. will be diagnosed with prostate cancer in 2026, and about 36,000 will die of it.

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