American Cancer Society now recommends PSA tests every two years from age 50

The American Cancer Society on Thursday began recommending routine PSA blood tests for prostate cancer, calling for average-risk men to be tested every two years starting at age 50.

The recommendation extends through age 69 under the guidelines published in CA: A Cancer Journal for Clinicians. For Black men, those with a strong family history and others at higher risk, the society advises annual tests starting at 45.

“Men need to get tested, and higher-risk men need to get tested earlier,” Dr. Phillip Koo, chief medical officer of the Prostate Cancer Foundation, told USA Today.

PSA tests carry risks, too. False positives and overdiagnosis may result in unneeded biopsies or therapy, with possible consequences including sexual dysfunction, urinary incontinence and bowel problems.

Other medical groups differ. The American Academy of Family Physicians does not recommend PSA screening, while the American Urological Association advises it from 55 to 69 for men expected to live more than 10 to 15 years, and from age 40 for higher-risk men.

Why the guidance changed

Since 2010, the society had advised average-risk men to discuss testing with their doctors, stopping short of recommending it directly. Its experts believed that left too many men unscreened, and a randomized European study with over two decades of follow-up helped shape the new advice, according to NBC News.

The European study, published in 2025, found a 13% lower prostate cancer death rate among those assigned to PSA testing than among unscreened men in the 55–69 age group.

“We thought it was really important to update our prostate cancer guidelines, because now there is true evidence that prostate cancer screening with the PSA test, a blood test, can actually decrease one's chance of dying from prostate cancer,” society chief scientific officer Dr. William Dahut said in an interview released by the society and quoted by ABC News.

Guidance for older men

The guidelines advise men ages 70 to 74 to make a decision with their doctors about continued screening because the balance of benefits and harms is uncertain.

The society does not recommend screening for most men 75 and older, though The Associated Press reported that the guideline discourages it for men 80 and older. Dahut told The Boston Globe that therapy's harms are more likely to outweigh its benefits for men 75 and older.

The society also discourages screening regardless of age when a man’s life expectancy is less than 10 years.

Former President Joe Biden underwent prostate cancer screening at age 72 in 2014, then received a diagnosis in May 2025 of prostate cancer that had spread to his bone. Biden, 83, had followed federal advice against PSA testing after age 70, NBC News reported.

Biden writes in his memoir, due out Nov. 17, that the testing guidance meant he was treated "no differently from any other 82-year-old man in America. Maybe I should have been."

I want to share a brief update.

My presidential memoir, PROMISE ME, AMERICA, is coming out on November 17th. I hope you'll read it. It covers my years as President. The challenges we faced, the decisions I made, and why I made them. It's about who we are as a nation. What we

— Joe Biden (@JoeBiden) November 8, 2026

Follow-up care

The guidelines advise a repeat test within two weeks to three months for men with elevated PSA levels, followed by offers of MRI and biomarker tests for confirmed elevations to help guide biopsy decisions. For men diagnosed with low-risk cancer, the guidelines recommend offering active surveillance as the first option.

Black men face at least twice the risk of dying from prostate cancer as other men, according to the U.S. Centers for Disease Control and Prevention.

National Cancer Institute data show that in 2023, about 40% of men in the 55–69 age group had received a PSA test during the preceding year, compared with about 33% of Black men.

Federal advice has changed over time. The U.S. Preventive Services Task Force recommended against PSA testing in 2012. In 2018, the task force advised men in the 55–69 age group to discuss periodic tests with their doctors, and an update to that advice is in progress.