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Prostate Cancer Screening Guidelines Have Changed: What Men 50-Plus Should Know

In a major shift, the American Cancer Society now recommends regular PSA testing

3-minute read

Rachel Nania,

AARP

Published November 12, 2026

Doctor explaining medical treatment on a digital tablet to a male patient in a doctor’s office

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For the first time, new guidelines from the American Cancer Society recommend routine prostate cancer screening, marking a major shift in screening for the second-leading cause of cancer death among U.S. men.

Under the guidelines, published Nov. 12, the American Cancer Society (ACS) says men ages 50 to 69 at average risk for prostate cancer should undergo prostate-specific antigen (PSA)—based screening every two years.

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Black men and men with a strong family history of the disease should get screened annually, beginning at age 45. And men ages 70-plus should discuss the risks and benefits of screening with their doctors, though experts generally recommend against screening after age 80.

The change reflects stronger evidence that regular screening can help detect cancer earlier, before it spreads, and reduce the risk of dying from the disease, according to the authors of the guidelines, published in CA: A Cancer Journal for Clinicians. Previous recommendations stopped short of recommending routine screening, instead encouraging men to discuss the decision with their doctor, an approach known as shared decision-making.

“We think it’s a very positive change,” says Dr. Robert Smith, director of the Center for Early Cancer Detection at the American Cancer Society and a senior author of the report.

Smith says that for many years, prostate cancer screening guidelines reflected a “general sense of uncertainty” about whether the benefits of screening outweighed potential harms, such as unnecessary biopsies or overtreatment of nonaggressive cancers. Now, he says, “we have a better sense of the value of the test in reducing the incidence rate of advanced disease and death,” along with a clearer understanding of how to minimize potential harms.

High-risk individuals need more frequent screening

Prostate cancer is one of the most common cancers in men. It’s estimated that nearly 334,000 new cases of the cancer will be diagnosed this year in the U.S. and that about 36,000 men will die from it.

Black men bear a greater burden when it comes to these statistics. The rate of prostate cancer is 67 percent higher in Black men than white men, and mortality rates are nearly double those of white men — “an inequity that needs immediate reversal,” said Dr. William Dahut, chief scientific officer at the American Cancer Society and a contributing author of the study, in a news release. The goal of encouraging earlier and more frequent screening in this population is to help reduce these disparities, he says.

Age is another risk factor for prostate cancer. It’s rare in men younger than 40, the American Cancer Society says, and risk “rises rapidly” after age 50. Having a father or brother with prostate cancer more than doubles a man’s risk of developing it. This is why men with a strong family history should also begin screening earlier, at age 45, Dahut says.

Outcomes are better with early treatment

Symptoms of prostate cancer are often absent in the earlier stages of the disease, when it’s easiest to treat. However, problems urinating — this can include a weak urine stream or frequent urination, especially at night — and blood in the urine or semen can be early-warning signs.

A PSA blood test can indicate the presence of prostate cancer, since higher PSA levels are associated with a greater likelihood of having the disease. If your PSA level is high, your doctor may recommend repeating it before ordering additional testing to confirm cancer, such as an imaging test or a biopsy.

“The PSA test is just the first step in a screening process,” Smith said in the news release. “Secondary testing for men with elevated PSA levels determines who needs a biopsy if an individual has prostate cancer, and if so, who needs immediate treatment and who can be safely monitored via active surveillance.”

The American Cancer Society’s new prostate screening recommendation differs from guidelines issued by other groups, including the United States Preventive Services Task Force, last updated in 2018. However, Smith says that when major groups such as the cancer society update their recommendations, insurers often follow and cover the cost of screening services.

If a PSA test isn’t covered by your insurance, Smith says, it’s not a particularly expensive test. Medicare covers an annual PSA blood test.

“Prostate cancer outcomes are much better when [the cancer is] found earlier on,” Dahut said. The five-year survival rate for prostate cancer that has not spread is greater than 99 percent.

“So having the information available to determine whether or not you should be treated, I do think, adds great value. And that’s one of the reasons why we have changed our recommendations,” Dahut added.

Rachel Nania is an award-winning health editor and writer at AARP.org, who covers a range of topics including diseases and treatments.

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