There's new guidance for prostate cancer testing. What you should know - USA Today

The American Cancer Society now recommends men ages 50 to 69 get a blood test every other year to screen for prostate cancer, the second most common cause of cancer deaths in men.

The guidance, released Nov. 12, is more aggressive than the advocacy group's 2010 recommendation that men should decide with their doctor whether to undergo screening.

The American Cancer Society, or ACS, said average-risk men in their 50s and 60s should undergo a prostate-specific antigen, or PSA, blood test every two years. Doctors should explain to patients potential benefits, limitations and harms before beginning screening, ACS said.

Men who face a higher risk − including Black men and those with a strong family history of the disease − should get screened every year beginning at age 45 and continuing through the age of 69, ACS said.

Men aged 70 to 74 should decide whether to continue their screening, ACS said, citing uncertainty on the balance of benefits and harms in that age group. ACS doesn't recommend screening for men aged 75 years and older. The group acknowledged some healthy men 75 and older might choose to continue screening but recommended they discuss such a decision with their doctor or other health care provider.

While PSA testing can lead to early detection of prostate cancer, potential risks can include false positives, detecting cancers that aren't deadly, unnecessary biopsies or treatments and patient anxiety. Still, advocates of PSA testing say screening and follow-up monitoring can help detect aggressive, potentially deadly tumors earlier.

"It's great that they (ACS) are being more forceful with the recommendations," said Dr. Phillip Koo, chief medical officer of the Prostate Cancer Foundation. "Men need to get tested, and higher-risk men need to get tested earlier."

ACS cited a long-term European study that followed men ages 55 to 69 who were randomly assigned to a group that received PSA testing or a group that did not undergo screening. The 2025 study concluded prostate cancer deaths were 13% lower in the screening group compared to the non-screened group.

ACS officials believe that PSA screening combined with more nuanced follow-up MRIs and biomarker tests can help doctors identify aggressive cases of prostate cancer that are more likely to harm men. ACS estimates 333,830 U.S. men will be diagnosed with prostate cancer in 2026 and 36,320 men will die from the disease.

The updated guidance aims to reduce sickness and death "through the early detection of clinically significant prostate cancers - those that actually pose a real risk to life," said Dr. Robert Smith, a senior vice president and director of ACS's center for early cancer detection.

The idea that early detection is better has generated significant debate over the past two decades among cancer researchers, doctors and advocates.

Some researchers have argued PSA testing can lead to false-positive results and overdiagnosis of prostate cancer, identifying low-risk tumors that grow slowly and might not harm a man over the course of his lifetime. Risks from elevated PSA tests can include men receiving unnecessary biopsies. Men also might undergo treatment of a tumor that is unlikely to harm them, and experience side effects from radiation treatment that can include loss of urinary control, bowel problems and sexual dysfunction.

In 2018, the influential U.S. Preventive Services Task Force recommended that men 55 to 69 years old should consider periodic PSA testing in consultation with their doctor about the potential benefits and harms. That was a change from 2012 when the task force, weighing potential benefits of early detection and risks, recommended against such screening.

Smith said the task force's 2012 recommendation against PSA testing likely prompted many doctors and patients to skip screening altogether, and during that time "more men were increasingly being diagnosed with advanced disease."

American Cancer Society researchers said the updated guidance on PSA testing should be combined with more follow-up testing to avoid overdiagnosis or potential treatment harms, Smith said. Those follow-up tests could include a second PSA test, an MRI and biomarker testing before a patient undergoes a biopsy.

Those who are diagnosed with less aggressive prostate cancer should undergo "active surveillance," Smith said, noting such men ultimately may never get radiation or other types of cancer treatment.

Dr. William Dahut, the ACS's chief scientific officer, said the updated guidance on PSA screening and more nuanced follow-up testing should cut down on the number of unnecessary biopsies.

"We've gotten much better at determining who should be biopsied and then who we can safely defer treatment based on an active surveillance protocol," Dahut said.

Former President Joe Biden was screened for prostate cancer in 2014 at the age of 72. He was diagnosed in May 2025 with prostate cancer that had spread to the bone after a nodule was discovered on his prostate following urinary symptoms.

In new his memoir, "Promise Me America," Biden noted that testing guidance at the time meant he was treated "no differently from any other 82-year-old man in America. Maybe I should have been.”

In a recent interview with People, Biden said his cancer outlook "looks very positive" and that people with his late-stage cancer can live for years with treatment.

In the interview, the former president said White House doctors "are doing what the whole entire medical profession is doing ... I had some discomfort, and Jill thought, 'Why isn’t that test done for men who are in their 70s?' And there wasn’t any particular [sign] except recurring pain."