For the first time in 16 years the American Cancer Society (ACS) has updated its guideline for prostate cancer screening as it drives to boost detection of the disease before it spreads.
Key changes include the recommendation of annual prostate-specific antigen (PSA)-based screening beginning at 45 years old for Black men and men with a strong family history of prostate cancer, given their overall high risk of the condition.
The new guidelines also recommend PSA-based screening every two years for average-risk men aged 50-69, with clinicians ensuring patients understand the potential benefits, limitations, and harms before starting screening.
The guideline update is published in a report in CA: A Cancer Journal for Clinicians, the flagship journal of ACS.
Since the previous ACS guideline was published in 2010, the agency noted there is now stronger evidence showing that screening for prostate cancer with a PSA test significantly reduces prostate cancer mortality and diagnosis of advanced-stage disease.
A PSA test is a simple blood test that measures the level of prostate-specific antigen. There have been advances in approaches to an elevated PSA that can reduce the risk of adverse outcomes associated with diagnosing and treating prostate cancer that may not be life-threatening.
“PSA testing remains the conerstone of detecting prostate cancer early, and we now have stronger evidence of its benefits,” said Dr. Robert Smith, senior vice president, early cancer detection science, and director, Center for Early Cancer Detection at the American Cancer Society and senior author of the report.
“We also have better approaches to catching lethal tumors while avoiding unnecessary tests for slow-growing cancers that may never need aggressive care. The PSA test is just the first step in a screening process.”
Prostate cancer is one of the most common cancers and is the second leading cause of cancer death in men in the United States. The ACS estimates that 333,830 men will be diagnosed with prostate cancer in 2026, with 36,320 men dying of the disease. Incidence and mortality rates display substantial disparities across racial and socioeconomic groups.
According to ACS, the updated guideline reflects modern evidence on the efficacy of PSA-based screening to reduce prostate cancer deaths and diagnoses of advanced-stage disease. The updated recommendations are intended to reduce the uncertainty about the effectiveness of prostate cancer screening, and to emphasize the identification of clinically significant cancers earlier, particularly among men at increased risk, and to avoid aggressive treatment of prostate cancers that are not life-threatening.