What men need to know after a major update to prostate cancer guidelines
[November 13, 2026]
By LAURAN NEERGAARD
WASHINGTON (AP) — Middle-aged men should undergo regular screening for
prostate cancer, the American Cancer Society said Thursday in a major
change to its guidelines.
The screening involves a simple blood test, and men at average risk of
getting prostate cancer should receive that PSA test every two years
between the ages of 50 and 69, the cancer society advised.
Men at high risk, including Black men and men with a strong family
history of prostate cancer, should get yearly PSA checks and start
earlier, at age 45.
Thursday’s guideline update marks a shift in thinking about routine
blood tests for PSA, or prostate-specific antigen.
Since 2010, the cancer society has recommended that men at average risk
talk with their doctors about whether and how often to get PSA tests.
That’s a protein produced by both normal and cancerous prostate cells,
meaning a high level might signal a tumor but also could be from a
benign enlarged prostate or be a temporary spike from vigorous exercise.
Catching prostate cancer early without overtreating
Prostate cancer is highly survivable if caught early, but widespread PSA
testing in the past was blamed for overtreatment of slow-growing tumors
and unnecessary follow-up testing in men who turned out to not have
cancer.
The updated advice comes after advances in understanding how regular PSA
testing can help catch prostate cancer before it spreads and becomes
harder to treat, as well as how to reduce potential harms from
screening, according to the cancer society. That includes steps such as
repeating a PSA test to be sure it’s really high or adding an MRI scan
to help identify who needs a biopsy, as well as monitoring rather than
aggressively treating low-risk tumors.
A prostate cancer specialist not involved with the guideline said the
change will be especially helpful for primary care doctors who introduce
cancer screenings to patients but may be less familiar with the
complexities.
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 “This has taken ambiguity out of it.
They are basically saying, ‘Do it,’” said Dr. Ash Tewari, who leads
the urology department at Mount Sinai's Icahn School of Medicine in
New York. “This guideline will only make things easier for men and
hopefully it will have more grandfathers eating dinner with their
family 10 years from now.”
Still talk with your doctor about your prostate
cancer risk
There still needs to be a doctor-patient conversation about the pros
and cons, the cancer society guideline stresses.
“We want to find the right balance,” Tewari agreed. “Patients need
to understand that their risk of prostate cancer differs,” which
explains why the recommendations aren't one-size-fits-all.
What is a strong family history? The cancer society says that means
having one close relative — a father, brother or son — diagnosed
with prostate cancer before age 65, or multiple close relatives
diagnosed at any age. That puts them in the high-risk category for
yearly PSA checks starting at 45. But if men have just one close
relative with prostate cancer diagnosed after 65, they should still
start screening at 45 but can go two years between testing.
How long should screening continue? It's not for men of any age
whose health is so poor that they aren't expected to live another 10
years. For everyone else, the guideline advises talking with a
doctor at age 70 about the choice, saying benefits are less clear.
The cancer society no longer recommends screening at 75 — while
acknowledging that particularly healthy 75- to 79-year-olds may
choose to continue — and discourages it once men turn 80.
Prostate cancer is one of the most common cancers in men. The cancer
society estimates more than 333,000 men in the U.S. will be
diagnosed with prostate cancer in 2026, and about 36,000 will die of
it.
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