Guideline update follows advances that reduce the potential harms of PSA testing
Middle-aged men should undergo regular screening for prostate cancer, the American Cancer Society said Thursday, in a major change to its guidelines. The society said men at average risk of the disease should get the PSA blood test every two years between the ages of 50 and 69.
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, according to the guideline.
Prostate cancer is one of the most common cancers in men. The cancer society estimates more than 333,000 men in the United States will be diagnosed with the disease in 2026, and about 36,000 will die of it.
Thursday’s guideline update marks a shift in thinking about routine blood tests for PSA, or prostate-specific antigen. Since 2010, the society has recommended that men at average risk talk with their doctors about whether to get regular PSA tests.
PSA is a protein produced by both normal and cancerous prostate cells, according to the cancer society. A high level might signal a tumor, but it also could come 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 not to have cancer.
The society said the updated advice follows advances in understanding the benefits of PSA testing and how to reduce its potential harms.
Those steps include repeating a PSA test to be sure a high result is really high, or adding an MRI scan to help identify who needs a biopsy.
The guideline also addresses when screening should wind down. Starting at 70, men should talk with their doctors about whether it is beneficial to continue routine PSA checks, the society said. The guideline discourages screening for men 80 and older, and for men of any age who are not expected to live another 10 years because of other health problems.