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The American Cancer Society now recommends routine PSA-based prostate cancer screening for all men — moving away from the previous shared decision-making model. Average-risk men should screen every two years starting at 50, while Black men and those with a strong family history should screen annually from age 45. The update reflects stronger evidence that screening saves lives and that modern tools can reduce overtreatment risks.
The American Cancer Society (ACS) has issued its first prostate cancer screening guideline update since 2010 — and it marks a meaningful shift. Rather than relying on "shared decision-making," the new guidance makes a direct recommendation: men should get regular PSA-based screening. Average-risk men (generally non-Black men with no family history) should screen every two years from ages 50 to 69, while high-risk men — including Black men and those with a first-degree relative diagnosed before age 65 — should screen annually starting at age 45.
The update is backed by long-term data from the European Randomized Study of Screening for Prostate Cancer (ERSPC), which showed a 13% reduction in prostate cancer mortality and a more than 40% drop in metastatic diagnoses with PSA screening. Advances in MRI imaging and biomarker testing now help clinicians better distinguish aggressive cancers from slow-growing ones, reducing unnecessary biopsies and overtreatment.
Key Takeaways:
Why it matters: Prostate cancer is the second most common cancer in U.S. men, with nearly 334,000 new diagnoses and over 36,000 deaths expected this year. This guideline gives clinicians a clearer, evidence-based roadmap — and directly addresses racial disparities, since Black men face 67% higher incidence and double the mortality rate compared to white men.
