American Cancer Society now recommends routine PSA tests: every two years from 50, yearly from 45 for Black men

The American Cancer Society on Thursday released an updated prostate cancer screening guideline that, for the first time, directly recommends regular PSA blood testing for men at average risk, according to the society's press release. AP and Reuters both reported the change. The previous guideline, published in 2010, only advised most men to have a shared decision-making talk with a clinician.

What the new guideline says

Per the society's release, the recommendations are:

• Average-risk men, 50 to 69: a PSA-based screening test every two years, after the clinician explains the benefits, limits and harms.
• Black men and men with a strong family history, 45 to 69: annual PSA-based screening. "Strong" means a first-degree relative diagnosed before 65, or several first-degree relatives diagnosed at any age.
• Non-Black men with one first-degree relative diagnosed at 65 or older, 45 to 69: screening every two years.
• Ages 70 to 74: individual decision-making, because the balance of benefit and harm is uncertain.
• 75 and older: not recommended; some very healthy men aged 75 to 79 may choose to continue after talking to a clinician. Not recommended at 80 and older, or for men not expected to live another ten years.

What counts as an elevated result

The society sets the threshold at a PSA of 3.0 ng/mL or higher for men 45 to 69, and 6.5 ng/mL or higher for men 70 to 74. An elevated result should be repeated within two weeks to three months. If it is confirmed, the guideline says men should be offered an MRI and/or a validated biomarker test to guide any biopsy decision. Men diagnosed with low-risk disease should be offered active surveillance first.

Why the society changed course

The society says stronger evidence now shows PSA screening significantly reduces prostate cancer deaths and diagnosis of advanced disease. It also points to better ways of handling an elevated PSA that cut down on unnecessary biopsies and treatment of slow-growing tumors. Dr. Robert Smith, the report's senior author, said PSA testing "remains the cornerstone of detecting prostate cancer early." The guideline is published in CA: A Cancer Journal for Clinicians.

The society estimates 333,830 US men will be diagnosed with prostate cancer in 2026 and 36,320 will die of it, making it the second leading cause of cancer death in men.

What it means in practice

A guideline is not a coverage rule. Whether a PSA test is covered at no cost depends on the plan and on other bodies' recommendations, and we have not seen any insurer announce a change. Anyone planning around this should ask their plan how a screening PSA is billed. Self-employed owners and small-business teams buying individual or small-group coverage are the people most likely to find out at the lab counter.

For men 45 and older who are Black or have an affected father or brother, the practical change is the starting age and the yearly interval. A conversation with a clinician is still the first step: the society itself says the test is only the first stage of a screening process.

Sources: American Cancer Society press release, Nov. 12, 2026; AP and Reuters coverage of the guideline. This is general information, not medical advice.