American Cancer Society Backs PSA Tests Every Two Years From 50
The American Cancer Society issued new guidelines on November 12, 2026, recommending a PSA blood test every two years for men 50 to 69. Black men and men with a strong family history should start annual screening at 45, the group said.
The American Cancer Society on Thursday, November 12, 2026, issued new guidelines recommending that all men ages 50 to 69 get a prostate-specific antigen (PSA) blood test every two years. Men who want to know prostate cancer screening ages now have a direct rule instead of a case-by-case discussion.
Black men and men with a strong family history of prostate cancer should start annual screening at 45, the guidelines said. The update was published in CA: A Cancer Journal for Clinicians.
It replaces guidance from 2010 that stressed "informed decision-making" and urged men to discuss screening with a health care provider.
"This is truly a reversal," said Dr. Philipp Dahm, a professor of urology at the University of Minnesota who was not involved in the guidelines.
Dr. William Dahut, the society's chief scientific officer, said the evidence has changed since 2010. Doctors have found ways to reduce the harms of screening, he said. Long-term studies, mostly in Europe, now show lower prostate cancer deaths among men screened every two years.
At 70, the advice shifts back. "Once you hit age 70, then you're back in the individual decision-making process," Dahut said.
What the PSA test measures
A PSA test measures a protein made by the prostate gland. High levels can point to cancer, but also to an enlarged prostate or, less often, an infection.
The guidelines define an abnormal result as 3 nanograms per milliliter or higher for men 69 and younger. For men 70 to 74, the threshold is 6.5 ng/mL or higher.
Dr. Yaw Nyame, an associate professor at the Fred Hutchinson Cancer Center who served on the expert panel reviewing the update, said a first PSA in a man's 40s or 50s sets a baseline. "If that first PSA is under 1 ng/ml, your lifetime risk of prostate cancer is much lower," he said.
Why the debate persists
Prostate cancer accounts for about 2.5 percent of all deaths among U.S. men. It is the second-leading cause of cancer death among men, behind lung cancer.
Diagnoses climbed about 3% per year from 2014 through 2022, with more late-stage cases. Dahut said the rise is driven mainly by men with advanced disease.
Universal screening has long been controversial. Evidence for regular PSA testing is somewhat limited, and treating every diagnosed case carries documented harms. Prostate cancers are typically slow growing and may never cause problems.
Dr. Neeraj Agarwal, a medical oncologist at the Dana-Farber Cancer Institute/Harvard Cancer Center who was not involved in the update, said the old approach left many men without a test. "Leaving it to each patient and doctor meant a lot of men were simply never offered the test. A clear recommendation fixes that," he said.
