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American Cancer Society revises guidelines, urges routine PSA screening for prostate cancer

By · Via STAT Health · Published by Everything Blog

In short

The updated framework directs average-risk men between 50 and 69 to undergo blood tests every two years, while high-risk individuals like Black men must start annually at 45. A PSA reading of 3.0 nanograms per milliliter or higher is now established as the benchmark cutoff for an elevated result within these age cohorts. To prevent overdiagnosis, suspicious readings must be validated with two separate tests and an MRI or biomarker assessment prior to a biopsy. Men who are ultimately diagnosed with slow-growing tumors will be guided toward active surveillance rather than immediate intervention.

Key points

  • The new recommendations reverse a 2010 policy that left prostate cancer screening to indi…: The new recommendations reverse a 2010 policy that left prostate cancer screening to individual patient discretion.
  • Active surveillance is prioritized over immediate medical treatment for patients diagnose…: Active surveillance is prioritized over immediate medical treatment for patients diagnosed with slow-growing or indolent cancers.
  • The U.S. Preventive Services Task Force currently advises against population-wide screeni…: The U.S. Preventive Services Task Force currently advises against population-wide screening but plans to issue an update.

Sources checked by our analysis pipeline: 1

In a major change to screening guidelines, the American Cancer Society recommended on Thursday that American men between ages 50 and 69 at an average risk of prostate cancer should test their prostate-specific antigen (PSA) blood levels every two years.

The prior guidelines, released in 2010, left testing for average-risk men to their discretion, after assessing cancer risk with a physician.

Similarly, PSA testing recommendations were strengthened for high risk groups — Black men and men with a strong family history of prostate cancer. They are now encouraged to get PSA-based screening yearly starting at 45. Black men in particular disproportionately die from prostate cancer, and the guideline authors said they hope that increased surveillance will reduce the number of Black patients presenting with cancers at advanced stages.

Then, starting at 70, the decision on whether to continue screening becomes individualized as the balance of benefit and harm is not as clear after that age. Screening should be interrupted after 80, or in men who are not expected to live another 10 years.

The changes reflect recent findings that screening…

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