American Cancer Society revises guidelines to recommend routine PSA screening

On November 12, 2026, the American Cancer Society revised its screening guidelines to recommend routine biennial PSA blood testing for average-risk men aged 50 to 69. Reversing its 2010 stance, the ACS cited evidence that PSA screening, combined with pre-biopsy MRI scans, lowers mortality while minimizing overtreatment. To address stark health disparities, the ACS calls for annual screening starting at age 45 for Black men, who face double the prostate cancer mortality rate of white men.

General PSA screening recommendations

• ▪The 2026 American Cancer Society guidelines establish a PSA threshold of 3.0 nanograms per milliliter or higher as elevated for men aged 45 to 69 years old
• ▪The American Cancer Society updated guidelines advise repeating PSA blood tests followed by MRI scans or additional biomarker tests before scheduling a prostate biopsy to limit unnecessary procedures
• ▪The American Cancer Society updated its guidelines, recommending routine prostate-specific antigen blood testing every two years for average-risk men aged 50 to 69

Screening recommendations for specific age and risk groups

• ▪The American Cancer Society advises stopping prostate cancer screening for men aged 80 and older or for those with a life expectancy under 10 years
• ▪The American Cancer Society recommends annual PSA screening starting at age 45 for Black men due to higher incidence rates and double the mortality risk compared to white men
• ▪For men aged 70 to 74, the American Cancer Society advises individualized decision-making regarding PSA screening after discussing benefits and potential harms with healthcare providers
• ▪The 2026 American Cancer Society guidelines recommend annual PSA screening starting at age 45 for men with a significant family history of prostate cancer

Prostate cancer treatment options

• ▪American Cancer Society Chief Scientific Officer William Dahut stated that improvements in robotic surgery and targeted radiation have increased care quality and reduced treatment side effects for prostate cancer
• ▪The 2026 American Cancer Society guidelines advise active surveillance rather than immediate active treatment for men diagnosed with low-risk prostate cancer

Prostate cancer disparities in Black men

• ▪American Cancer Society Chief Scientific Officer William Dahut stated that earlier screening recommendations for Black men aim to reduce prostate cancer disparities and ease disease burden
• ▪Black men face a 67% higher incidence rate of prostate cancer and nearly double the mortality rate compared with white men in the United States

Task Force screening stance

• ▪The U.S. Preventive Services Task Force has not updated its prostate cancer screening guidelines since new clinical evidence emerged in 2025
• ▪The U.S. Preventive Services Task Force recommends individualized decision-making for PSA screening rather than routine population screening, but announced an upcoming update to its guidelines

Rationale for updating screening guidelines

• ▪The American Cancer Society restored routine screening after accumulating evidence showed PSA testing combined with targeted MRIs, improved biomarkers, and active surveillance reduces disease-specific mortality
• ▪The American Cancer Society dropped routine PSA screening in 2010 because the blood test lacked specificity, leading to unnecessary biopsies and overtreatment of slow-growing tumors