A ‘clear recommendation’ for men: Get screened for prostate cancer

The American Cancer Society (ACS) released updated prostate cancer screening guidelines on November 12, 2026, marking the first revision since 2010. The new guideline issues a direct recommendation for prostate-specific antigen (PSA)-based screening every two years for average-risk men aged 50 to 69, with clinicians ensuring patients understand potential benefits, limitations, and harms before starting. For Black men and men with a strong family history of prostate cancer, ACS recommends annual PSA screening beginning at age 45. Non-Black men with a single first-degree relative diagnosed at age 65 or older should also be screened every two years starting at 45.

The changes reflect stronger evidence since 2010 showing that PSA screening significantly reduces prostate cancer mortality and advanced-stage diagnoses. ACS conducted a systematic evidence review and commissioned a modeling study to evaluate benefits and harms. An interdisciplinary Guideline Development Group updated the recommendations, which are published in CA: A Cancer Journal for Clinicians.

Dr. Robert Smith, senior vice president of early cancer detection science at ACS and senior author of the report, said, "PSA testing remains the cornerstone of detecting prostate cancer early, and we now have stronger evidence of its benefits." He added that better approaches now exist for catching lethal tumors while avoiding unnecessary tests for slow-growing cancers. The PSA test is the first step; secondary testing for elevated PSA levels determines who needs a biopsy and who can be monitored via active surveillance.

Prostate cancer is the second leading cause of cancer death in U.S. men. ACS estimates 333,830 men will be diagnosed in 2026 and 36,320 will die from the disease. Dr. William Dahut, chief scientific officer at ACS, noted that Black men experience a 67% higher incidence and nearly double the mortality rate compared with White men, calling it "an inequity that needs immediate reversal." In Washington, D.C., which has the highest per capita prostate cancer death rate nationally, Black men have an incidence rate of 161 cases per 100,000 versus 99 per 100,000 for White men, according to Dr. Arnold Baskies, a surgical oncologist and former ACS National Board chairman.

Under the updated guidelines, men with elevated PSA levels should undergo a second blood test to confirm results. If levels remain high, doctors may use MRI or additional biomarker testing to determine whether a biopsy is necessary. Dr. Baskies noted that PSA "can be elevated from noncancerous reasons." ACS's advocacy affiliate, ACS CAN, will advocate for coverage of prostate screening services, including follow-up testing, with no cost sharing. Dr. Shanthi Sivendran, interim chief patient officer at ACS, described screening as "an early warning system for your health."