What men need to know after a major update to prostate cancer guidelines

The American Cancer Society announced significant updates to its prostate cancer screening guidelines, emphasizing the importance of regular screenings for middle-aged men. Men at average risk should undergo a simple blood test called a PSA test every two years between the ages of 50 and 69. However, those at higher risk, such as Black men and individuals with a family history of prostate cancer, should start receiving these screenings annually from age 45.

The updated guidelines represent a shift from previous recommendations, which advised men at average risk to discuss screening options with their doctors. The change reflects advances in understanding how regular PSA testing can help detect prostate cancer early while minimizing potential harms. This includes repeating PSA tests to confirm abnormal results and using MRI scans to identify those who may need a biopsy.

The guidelines also suggest monitoring low-risk tumors instead of aggressive treatment, which can reduce unnecessary biopsies and overtreatment.

Dr. Ash Tewari, a urology specialist, noted that the new guidelines will be particularly helpful for primary care doctors, providing clearer guidance on cancer screenings. However, the cancer society stresses that the decision to screen should involve a conversation between patients and their doctors, weighing the pros and cons based on individual risk factors and preferences. It's important to remember that prostate cancer screening decisions aren't one-size-fits-all, as risk varies among individuals.

Men with a strong family history of prostate cancer—defined as having one close relative diagnosed before age 65 or multiple close relatives diagnosed at any age—should begin annual PSA checks at age 45. While there's no upper age limit for screening, the cancer society advises considering health and life expectancy, particularly for men turning 70 or older.

The organization no longer recommends PSA screening for men over 75, except for particularly healthy individuals who may choose to continue. Prostate cancer remains one of the most common cancers in men, with over 333,000 new diagnoses expected in the U.S. in 2026, and around 36,000 fatalities.