New prostate screening guidelines from American Cancer Society are most specific yet; exams meant to prevent health issues

ATLANTA -- The American Cancer Society has updated its guidelines for prostate cancer screenings, encouraging more men to get tested at certain intervals instead of just starting conversations with their doctors.

In new guidelines released Thursday, the organization is now encouraging all men with an average risk of developing prostate cancer to start prostate-specific antigen blood testing, or PSA testing -- the main test used to screen for prostate cancer -- every two years between the ages of 50 and 69.

Men at a higher risk, such as Black men or men with a strong family history of prostate cancer, should get tested earlier, starting at 45, the organization says.

Men between 70 and 74 should talk to their doctors about the pros and cons of getting tested, the guidelines state, while men 75 and older, or those not expected to live another 10 years, should stop screening.

Men with elevated PSA test results can discuss with their doctors any potential need for additional MRI testing.

"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," ACS chief scientific officer Dr. William Dahut, a medical oncologist, said in an interview released by ACS.

Research has shown that Black men tend to have a higher chance of developing prostate cancer and are more than twice as likely to die from it than other men, according to the U.S. Centers for Disease Control and Prevention.

In the U.S., prostate cancer, where the cells in the prostate grow out of control, is one of the most common cancers impacting men, with more than 266,000 new cases reported in 2023 and more than 34,000 deaths in 2024, according to the according to the CDC

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An upward trend of PSA values is more worrisome than a single abnormal value. The ACS now recommends men with a PSA of 3.0 or higher get screened every year and men with a PSA of 2.5 or lower get screened every two years.

Prostate cancer screening guidelines are not universal among doctors groups. The CDC and the U.S. Preventive Services Task Force, for instance, do not explicitly recommend PSA testing at a specific age, leaving the decision to test and any benefit-risk discussions to men and their doctors, with only a recommendation that men 70 and older not get screened.

The American Academy of Family Physicians does not recommend PSA screening for prostate cancer at all.

The American College of Physicians recommends men discuss with their doctors the benefits and risks of screening, only recommending men between 50 and 69 years old get screened if they have a life expectancy of more than 10 to 15 years.

The American Urological Association recommends screening for men between 55 and 69 with a life expectancy with a life expectancy of more than 10-15 years, but those of higher risk should start screening at age 40.

Any official changes to official prostate cancer screening guidelines is expected to take years to get adopted, but many doctors follow ACS guidelines.

The risks of PSA testing include overdiagnoses, including false positive test results, and overtreatment, the CDC notes. It may also not translate into longer lifespans, since prostate cancers tend to grow slowly, and some treatments can cause more harms than benefits, such as urinary incontinence, erectile dysfunction or bowel problems.