Many men should regularly be screened for prostate cancer, experts said in guidelines released on Nov. 12.
The American Cancer Society says that men aged 50 to 69 with average risk should undergo prostate-specific antigen testing every two years.
The society is also recommending annual screening starting at 45 years of age for men deemed high risk, such as black men and men who either have had a first-degree relative—such as a father or brother—diagnosed with prostate cancer before 65 years of age, or multiple first-degree relatives diagnosed at any age.
The previous guidelines, released in 2010, did not recommend any regular screening. Instead, the guidelines said most men should consult with their healthcare providers about potentially being tested for prostate cancer.
Since the previous guidance was published, there is stronger evidence supporting prostate cancer screening significantly lowering death from prostate cancer, according to the American Cancer Society.
“These updated guidelines are a critical step toward preventing diagnoses of advanced disease, reducing premature deaths, and minimizing treatment-related harms,” Dr. Robert Smith, senior vice president for early cancer detection science at the society and senior author of the new guidelines, said in a statement.
“By making a direct recommendation for men to engage in screening and advocating for earlier and more frequent screening for Black men, our aim is also to help reduce prostate cancer disparities and ease the disease burden,” added Dr. William Dahut, chief scientific officer at the American Cancer Society.
“Black men experience a 67% higher incidence and nearly double the mortality rate compared with White men, an inequity that needs immediate reversal.”
If testing detected elevated levels of prostate-specific antigens, then secondary tests should be run to figure out whether men need a biopsy or a procedure that removes suspicious tissues from the prostate. The prostate is a walnut-shaped gland in males that produces fluid that transports sperm.
Prostate cancer is the most common cancer in the United States among men, and the second leading cause of cancer death among men in the country.
There will be 333,830 new cases in 2026, representing about 16 percent of all new cancer cases, and 36,320 prostate cancer deaths in 2026, or about 6 percent of all cancer deaths, according to projections from the American Cancer Society.
The relative five-year survival through 2022 was pegged at 98.2 percent.
Signs of prostate cancer include a weak flow of urine or having to urinate frequently. Treatment includes surveillance to monitor a patient until symptoms appear, surgery to remove a tumor in the prostate gland, and radiation therapy.
Very few prostate cancer cases are diagnosed among men younger than 55. In 2022, 95 percent of diagnosed cases were among men aged 55 and older, including 52 percent among men aged 55 to 69, according to the Centers for Disease Control and Prevention. From 2003 to 2022, the incidence was highest among men aged 70 and up.
Continuing prostate cancer screening among men aged 70 to 74 should be a decision made between a patient and their doctor, the American Cancer Society said on Thursday. That’s because the risk-benefit equation is uncertain for that age group.
Screening is not recommended for men aged 75 years and older, the society said, although men aged 75 to 79 who are “very healthy” may want to still screen after talking with their doctor, especially if their prostate-specific antigen level has been rising.
Screening is not recommended for men aged 80 and up, and for men not expected to live another 10 years.
