Men should be screened for prostate cancer, experts urge in new ‘clear recommendation’

Key Points:

• The American Cancer Society has updated its prostate cancer screening guidelines, now recommending biennial PSA screening starting at age 50 for average-risk men, and annual screening beginning at 45 for Black men and those with a strong family history, marking a shift from previous emphasis on shared decision-making.
• This change is based on stronger evidence that PSA screening reduces prostate cancer mortality, supported by long-term European studies showing a 13% decrease in deaths with regular screening every two years.
• PSA testing remains the primary screening tool, with abnormal levels defined as 3 ng/mL or higher for men under 70 and 6.5 ng/mL or higher for men aged 70-74, though elevated PSA can result from non-cancerous conditions.
• Prostate cancer is the second-leading cause of cancer death among US men, with rising diagnoses and more late-stage cases, highlighting an urgent need for increased screening to detect cancers early when survival rates exceed 99%.
• Despite the updated ACS guidelines, the US Preventive Services Task Force still recommends individualized decision-making for PSA screening, which affects insurance coverage, but the new ACS stance may influence future policy and improve access to comprehensive prostate cancer screening and follow-up care.