New prostate cancer screening guidelines include regular testing for most older men

The American Cancer Society on Thursday issued new prostate cancer screening guidelines that mark a major shift from its 2010 advice. The organization now recommends that men at average risk receive a prostate-specific antigen (PSA) blood test every two years between ages 50 and 69, according to the Associated Press report carried by WAVY.com. Black men and men with a strong family history — defined as one close relative diagnosed before age 65 or multiple close relatives diagnosed at any age — should begin yearly PSA testing at age 45. Men with a single close relative diagnosed after 65 should also start at 45 but can test every two years.

The guidelines replace the previous recommendation that men at average risk discuss with their doctors whether and how often to get PSA tests. Dr. Philipp Dahm, a urology professor at the University of Minnesota not involved in the guidelines, called the change "truly a reversal" in comments to The New York Times. The cancer society said it updated its guidance based on new evidence and changes in how doctors monitor and treat prostate cancers, including repeating PSA tests to confirm high levels, using MRI scans to determine who needs a biopsy, and monitoring low-risk tumors rather than treating them aggressively.

Dr. Ash Tewari, who leads the urology department at Mount Sinai's Icahn School of Medicine, told the AP the change removes ambiguity for primary care doctors: "This has taken ambiguity out of it. They are basically saying, 'Do it.'" The guidelines still stress the need for doctor-patient conversations about pros and cons. Screening is not recommended for men whose health is so poor they aren't expected to live another 10 years. At age 70, men should discuss with a doctor whether to continue, as benefits are less clear. The cancer society no longer recommends screening at 75, though particularly healthy men aged 75 to 79 may choose to continue, and discourages screening after age 80.

Prostate cancer remains one of the most common cancers in men. The cancer society estimates more than 333,000 U.S. men will be diagnosed in 2026 and about 36,000 will die from it, according to the AP report. The New York Times noted prostate cancer accounts for about 2.5 percent of all deaths among U.S. men.