The American Cancer Society (ACS) issued new prostate cancer screening guidance on Thursday, marking a clear shift from its 2010 recommendations. The updated protocol advises men to undergo regular prostate‑specific antigen (PSA) testing, with frequency and starting age tailored to risk factors such as race and family history.
Screening schedule for average‑risk men
For men considered to be at average risk, the ACS now recommends a PSA test every two years beginning at age 50 and continuing through age 69. After age 70, the guidance changes: men aged 70 to 74 should discuss the merits of continued screening with their physician, while those 75 and older are advised against routine testing.
High‑risk groups and earlier testing
Men identified as high risk—primarily because of race or a strong family history—should start testing earlier, at age 45. The Society calls for annual PSA testing for all Black men, citing their higher incidence of prostate cancer. Non‑Black men are also recommended to undergo yearly testing at age 45 if they have a close relative diagnosed before age 65, or if more than one relative has had the disease.
In cases where a non‑Black man has only one close relative diagnosed at age 65 or older, the ACS advises beginning PSA screening at 45 but limiting the interval to every two years rather than annually.
Context and comparison with prior guidance
The 2024 guidance diverges sharply from the ACS’s 2010 position, which stopped short of universal screening. The earlier recommendation encouraged men at age 50 to engage in shared‑decision making with their doctors about whether to be screened, mirroring the stance of the U.S. Preventive Services Task Force (USPSTF) at that time.
The USPSTF, a federal panel that regularly reviews evidence for preventive care, is currently revisiting its own prostate cancer screening recommendation. The article notes that the task force has recently undergone a leadership change, with anti‑vaccine Health Secretary Robert F. Kennedy Jr. overseeing a reorganization that introduced new members reportedly facing conflicts of interest. While the ACS’s new guidance stands on its own, the concurrent USPSTF review may influence future alignment across major health organizations.
By establishing concrete age thresholds and testing intervals, the ACS aims to provide clearer direction for clinicians and patients alike. The emphasis on annual testing for Black men and for those with strong familial risk reflects an effort to address disparities in prostate cancer outcomes.
Healthcare providers are encouraged to incorporate these recommendations into routine practice, while also considering individual patient preferences and overall health status. The ACS stresses that men should continue to engage in conversations with their physicians, particularly when approaching the upper age limits of the guideline.
Overall, the revised ACS guidelines represent a notable policy reversal, moving from a cautious, individualized approach toward a more proactive, population‑wide screening strategy for prostate cancer.
Steve Lopez is a Senior Editorial Columnist and Health & Public Policy reporter for News Raise. Steve focuses on healthcare advancements, medical technologies, and public health policies.
