The American Cancer Society (ACS) has issued updated guidelines recommending that most men aged 50 to 69 undergo prostate-specific antigen (PSA) blood tests every two years, while men at higher risk—including Black men and those with a family history of prostate cancer—should begin annual screenings at age 45.
The new recommendations, published Thursday in CA: A Cancer Journal for Clinicians, mark a shift from prior guidance that emphasized shared decision-making between patients and doctors regarding PSA testing. The ACS cited evidence of reduced prostate cancer mortality and lower rates of advanced-stage diagnoses in screened populations. A 2025 European study found that PSA testing in men aged 55-69 led to a 13% reduction in prostate cancer deaths compared to those who were not screened.
Prostate cancer remains the second leading cause of cancer deaths among U.S. men, with an estimated 36,000 deaths and 333,000 new cases projected for 2025. The ACS noted that better detection methods now allow for earlier identification of lethal tumors while minimizing unnecessary testing for slow-growing cancers that may not require aggressive treatment.
Who Should Be Screened and When?
- Men aged 50-69: PSA test every two years.
- Black men and men with a family history of prostate cancer: Annual PSA testing starting at age 45.
- Men aged 70-74: Should discuss PSA testing with their healthcare providers based on individual health and life expectancy.
The ACS emphasized that the updated guidelines aim to increase early detection while balancing potential harms, such as unnecessary treatments and side effects from false positives. Dr. William L. Dahut, chief scientific officer of the ACS, stated that the changes were intended to reduce metastatic disease and prostate cancer deaths while mitigating overtreatment.
Political Response to the Guidelines
Former President Joe Biden endorsed the new screening recommendations in a post on X (formerly Twitter), urging men to consult their doctors. Biden, who has advanced prostate cancer, highlighted the importance of early detection in a statement: “I know firsthand the toll of this disease, and I know that catching it early saves lives.”
Biden’s previous guidance, issued in March 2025, had suggested PSA testing every two to four years for average-risk men starting at age 50. The updated ACS guidelines now recommend more frequent testing for higher-risk groups.
Background on PSA Testing
PSA tests measure levels of prostate-specific antigen, a protein produced by both healthy and cancerous prostate cells. While PSA testing has been available for decades, its use has been controversial due to concerns about overdiagnosis and overtreatment. However, the ACS now cites stronger evidence supporting its benefits, including a reduction in advanced-stage diagnoses.
The new guidelines reflect a broader trend in cancer screening toward more proactive and risk-stratified approaches, particularly for populations with higher disease prevalence or mortality rates.