The American Cancer Society issued new guidelines on Thursday recommending that most men ages 50 to 69 undergo prostate-specific antigen (PSA) blood testing every two years to screen for prostate cancer.
The updated recommendations represent a shift from the organization’s 2010 guidance, which previously left the decision to screen up to individual discussions between patients and their physicians. The society now advocates for regular testing to improve early detection rates and reduce deaths from the disease.
Targeted Screening for High-Risk Groups
Under the new protocol, Black men and those with a strong family history of prostate cancer are advised to begin annual PSA screening at age 45. The society defines high-risk individuals as those with a first-degree relative diagnosed before age 65 or multiple first-degree relatives diagnosed at any age.
For men aged 70 to 74, the guidelines suggest that screening decisions should remain individualized based on personal health and life expectancy. Screening is not recommended for men 75 and older, as the potential risks of treatment often outweigh the benefits for that population.
“Men need to get tested, and higher-risk men need to get tested earlier,” said Dr. Phillip Koo, chief medical officer of the Prostate Cancer Foundation.
Evidence Behind the Policy Shift
The American Cancer Society said that its decision to resume recommending routine screening is supported by recent evidence showing that PSA testing can lower disease-specific mortality. While earlier concerns regarding overdiagnosis and overtreatment led to the 2010 policy of shared decision-making, officials said that improvements in clinical management have changed how care is delivered.
“We thought it was really important to update our prostate cancer guidelines, because now there is true evidence that prostate cancer screening with the PSA test, a blood test, can actually decrease one’s chance of dying from prostate cancer,” said Dr. William Dahut, the ACS’s chief scientific officer.
Impact on National Health Policy
The American Cancer Society’s move places it at odds with current federal recommendations. The U.S. Preventive Services Task Force, whose guidelines influence insurance coverage, currently suggests that PSA-based screening should be an individual decision for men aged 55 to 69. A version of the task force’s recommendation issued in 2018 carries a C grade, meaning it is not required for mandatory coverage under the Affordable Care Act.
“A clear recommendation fixes that,” said Dr. Neeraj Agarwal, who serves as a medical oncologist alongside his role as co-director of the Prostate Cancer Program at the Dana-Farber Cancer Institute/Harvard Cancer Center.
Prostate cancer remains the second leading cause of cancer death in U.S. men. The American Cancer Society estimates that 333,830 men will be diagnosed with the disease in 2026, with 36,320 deaths expected.
Former President Joe Biden, who has been treated for an aggressive form of prostate cancer, endorsed the update on social media. “So talk to your doctor, get screened, and let’s keep working to end cancer as we know it,” Biden wrote.
Clinical Context and Disparities
Prostate cancer is characterized by cells in the prostate grow out of control. According to data cited from the Centers for Disease Control and Prevention, the United States saw more than 266,000 new cases reported in 2023 and more than 34,000 deaths in 2024. In the updated figures for 2026, the American Cancer Society estimates more than 333,000 new diagnoses nationwide.
An equity gap emphasized by Dr. William Dahut, MD—who acts as chief scientific officer at the American Cancer Society and contributed to the study—in a publication released within CA: A Cancer Journal for Clinicians (the society’s primary journal) shows that Black men face a mortality rate nearly twice as high and an incidence rate 67% greater than white men.
ACS researchers Dr. Deana Baptiste, Tyler Kratzer, MPH, and Dr. Hormuzd Katki also contributed to the report alongside contributing author William Dahut.
Additional perspective comes from Dr. Yaw Nyame, an associate professor and physician at the Fred Hutchinson Cancer Center who was part of the expert panel tasked with reviewing the updated screening guidelines from the American Cancer Society.
Nyame said that a baseline PSA reading under 1 ng/ml indicates a much lower lifetime risk of the disease. Conversely, observing an upward trend of PSA values over time is considered more worrisome than a single isolated abnormal value.
Specializing in the treatment of genitourinary cancers at the Mayo Clinic located in Rochester, Minnesota, medical oncologist Dr. Childs observed that the prevalence of the condition is high enough that nearly every household has experienced its impact.
According to surgical oncologist and past chairman of the American Cancer Society’s National Board of Directors Dr. Arnold Baskies, these guideline updates hold considerable local significance in locations such as the nation’s capital, where the prostate cancer incidence rate reaches 161 per 100,000 among Black men compared with 99 per 100,000 for white men.
Lawmakers Introduce Legislation to Expand Insurance Coverage
John Boozman, an Arkansas Republican, and Cory Booker, a Democrat from New Jersey, introduced legislation aimed at expanding private health insurance coverage for preventive prostate cancer screenings specifically for men at high risk of developing the disease, including Black men.
Meanwhile, the Preventive Service Task Force, operating as a federally appointed panel of outside experts, has not changed its guidelines since new evidence became available in 2025. The task force continues to recommend against routine, population-wide PSA screening, suggesting individualized decision-making instead.
To learn more about the guidelines, individuals can visit cancer.org or call the American Cancer Society’s 24/7 helpline at 1-800-227-2345.
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