American Cancer Society now tells men 50 to 69 to get a PSA blood test for prostate cancer every two years, and Black men every year from 45

Men ages 50 to 69 at average risk should get a PSA blood test for prostate cancer every two years, the American Cancer Society recommended Nov. 12, in its first update since 2010.  Black men and men with a strong family history should start at 45 and test every year through 69.

The old guideline did not directly recommend screening.  It said most men should decide with their doctor.  The society says stronger evidence now shows PSA screening lowers the risk of dying of prostate cancer and of being diagnosed after it has spread.

What the new advice says

• Average risk, ages 50 to 69:  a PSA test every two years, after a clinician explains the benefits and harms.
• Black men, and men whose father or brother was diagnosed before 65 or who have several such relatives:  every year from 45 to 69.
• Men with one father or brother diagnosed at 65 or older:  every two years from 45 to 69.
• Ages 70 to 74:  decide with a doctor.  Age 75 and up, or anyone not expected to live 10 more years:  screening generally isn’t recommended, though some very healthy men 75 to 79 may continue.
• A high result (3.0 or more under 70, or 6.5 or more at 70 to 74) should be repeated within two weeks to three months.  If it stays high, men should be offered an MRI scan or another lab test before deciding on a biopsy, which removes tissue samples with a needle.

Men found to have a slow-growing, low-risk cancer should first be offered active surveillance, meaning regular checkups and tests instead of immediate surgery or radiation.

Why it matters

PSA, or prostate-specific antigen, is a protein made by the prostate gland, and high levels in the blood can be a sign of cancer.  Prostate cancer is the second-leading cause of cancer death among U.S. men.  The society estimates 333,830 men will be diagnosed and 36,320 will die of it in 2026.  Black men are diagnosed 67% more often than white men and die at nearly twice the rate.

The test has long been debated because it can flag cancers that would never cause harm, leading to biopsies and treatment that can cause incontinence and erectile problems.  The U.S. Preventive Services Task Force, a federal expert panel, still advises men 55 to 69 to decide for themselves and recommends against screening at 70 and older.  It is updating that 2018 advice.

Medicare covers a PSA test once every 12 months for men over 50, and patients pay nothing for the test itself.  Men with private insurance should check their costs.

Source:  American Cancer Society news release, Nov. 12, 2026; U.S. Preventive Services Task Force; Medicare.gov.