Conversely, the American Cancer Society recommends prostate cancer screening tests for all men

New data

In announcing the guidelines today, the ACS says its updates are based on new evidence since 2010 that shows that screening saves lives and that advances in case management can avoid the worrying harms of overdiagnosis and overtreatment. For many men with prostate cancer, it will never develop or cause damage during their lifetime, while treatment can lead to the risk of erectile dysfunction and urinary incontinence.

In the new guidelines, the ACS adds safeguards, first advising all men to be informed of the risks and benefits. If a PSA test is found to be elevated (defined as 3 ng/mL or more for men younger than 70 and 6.5 ng/mL or more for those 70 and older), the ACS recommends repeating the test before taking next steps.

If the number of repeat tests is still high, then men should undergo either a prostate MRI or a validated biomarker test to assess risk. Only if there is a strong suspicion of cancer, for example if a PSA test result is very high, should men have a prostate biopsy.

For men diagnosed with prostate cancer, active surveillance should be the initial management strategy for men whose cancer appears to be at low risk of growth or spread.

“By detecting aggressive cancers with a simple PSA blood test, you open the door to highly effective treatments that protect your future,” Dr. Shanthi Sivendran, interim chief patient officer at ACS, said in a statement. “In the meantime, low-risk outcomes can be safely managed through careful and active monitoring.”

Prostate cancer is one of the most common cancers in men and the second leading cause of cancer death among American men, notes the ACS. It is estimated that nearly 334,000 men will be diagnosed with prostate cancer in 2026, and more than 36,320 will die from it.