The American Cancer Society’s updated prostate cancer guidance recommends regular screening for men at average risk beginning at age 50. The recommendations were released Nov. 12 and put greater emphasis on routine testing for eligible men than earlier guidance did.
For men at average risk, the society recommends a prostate-specific antigen (PSA) blood test every two years from ages 50 to 69. Black men are advised to start annual screening at 45, as are men whose father, brother or son has had prostate cancer. For men with a close relative diagnosed with the disease, screening frequency may depend on their family history.
Men between 70 and 74 should talk with a doctor about whether to keep screening. Routine testing is not recommended for men aged 75 or older.
Prostate cancer is the second-leading cause of cancer death among men in the United States. When it has not spread beyond the prostate or nearby areas, the five-year relative survival rate is nearly 100%, according to the society.
Dr. Ash Tewari, chair of urology at the Icahn School of Medicine at Mount Sinai in New York City, said many men assume prostate cancer will affect someone else. Tewari, who has performed more than 10,000 prostate cancer operations, said treatment outcomes are often very good, but men may still need encouragement to get screened.
Screening uses a blood test to measure PSA, a protein made by both normal and cancerous prostate cells. Under the new guidance, a PSA result of 3 ng/mL or higher in men younger than 70 should be checked with a repeat test. Elevated PSA can have causes other than cancer, including an enlarged prostate, inflammation or infection.
Screening also has limitations. It can detect slow-growing cancers that may never cause serious problems, so the society advises men to discuss potential benefits and harms with a healthcare provider. For low-risk cancers, close monitoring is recommended as an initial option.
Tewari said effective treatments are available, and that getting to patients in time is important. Mount Sinai has introduced mobile screening vehicles to bring testing into neighborhoods. Its first unit began operating in New York City in 2022. Last month, another vehicle offered screenings outside the Atlanta Falcons-Chicago Bears game at Mercedes-Benz Stadium, in partnership with Emory University’s Winship Cancer Institute.
Tewari and Mount Sinai are also working to raise awareness through public outreach. Last month, actress Brooke Shields joined Tewari in a public service announcement encouraging screening and early detection. The effort is part of Tewari’s Million Strong Men Initiative, which aims to screen more than one million men.
Shields’ father, Frank, died of prostate cancer in 2003 at age 61. In the announcement, she says she wishes she had spoken with him about the disease sooner and emphasizes that prostate cancer can be treated when found early.
Tewari said families often wait until there is a diagnosis before talking about prostate cancer. He hopes earlier conversations will help men understand their risk, discuss screening with doctors and take action when appropriate.
The American Cancer Society estimates that more than 333,000 men in the U.S. will be diagnosed with prostate cancer in 2026, and about 36,000 will die from it.
