Cancer group says men should get regular PSA tests

The American Cancer Society has issued its first formal recommendation for routine prostate cancer screening. The medical organization advises that men undergo blood tests to detect the disease, a shift from its previous guidance which left the decision entirely to individual patients and their doctors.

Andrew Wolf, a cancer prevention expert at the University of Virginia and a coauthor of the new guidelines, explained the change. He noted that while the benefits of PSA testing have always been debated, recent data shows the tests reduce the risk of dying from the disease. Wolf stated that the potential harms of screening were previously considered too large relative to the small benefits, but the balance has now shifted.

The new guidelines set specific schedules based on age and risk factors. Men aged 50 to 69 who are at average risk should be screened every other year. For men at higher risk, specifically Black men and those with a family history of prostate cancer, the recommendation is to screen annually starting at age 45. The society does not recommend routine screening for men aged 75 and older unless previous PSA tests returned elevated results.

Wolf acknowledged that most prostate cancers grow slowly and may never cause harm, which created a historical fear of overtreatment. He cited sexual dysfunction and urinary incontinence as serious downsides of unnecessary biopsies and surgeries. However, the new rules aim to mitigate this risk by using MRI imaging or additional blood tests before ordering a biopsy.

This change places the American Cancer Society at odds with the U.S. Preventive Services Task Force, a group of federally appointed experts. The Task Force continues to endorse the previous model of shared decision-making, where patients consult their doctors to weigh the pros and cons of testing. The new ACS guidelines provide a more prescriptive path for the over 300,000 Americans diagnosed with prostate cancer each year.