American Cancer Society updates prostate cancer screening guidelines: Here's what men should know
FILE - Surgeons use a Da Vinci robot surgical device to perform a radical prostatectomy with lymph node dissection on a 66-year-old patient. (Photo by: ALBANE NOOR/BSIP/Universal Images Group via Getty Images)
The American Cancer Society Thursday updated its recommendations on when and how often men should get tested for prostate cancer, the second leading cause of cancer deaths in men.
Big picture view:
The age ranges for testing remain largely unchanged. But the American Cancer Society is now recommending a more defined timeline for testing based on age and potential risk factors.
The most common test involves the prostate-specific antigen, commonly referred to as the PSA. The organization is recommending PSA-based testing every two years for average risk men 50 to 69 years old. Previously, guidelines suggested decisions on whether to screen should be based on a discussion between the doctor and the patient.
It also recommends that Black men and those with a strong history of prostate cancer begin PSA testing at 45 years old.
Non-Black men with a single first-degree relative diagnosed at 65 or older should be screened every two years from ages 45 to 69.
Men with elevated PSA levels, 3.0 ng/Ml or higher for men 45 to 69 years old or 6.5 ng/mL or higher for men 70 to 74, should undergo repeat PSA testing between two weeks and three months after the first test, and should be offered MRI testing or a validated biomarker to guide biopsy decisions.
But as men reach 70, the screening recommendations change.
From ages 70 to 74, the organization recommends individualized decision-making on screenings with your doctor.
ACS does not recommend screening for men 75 or older, though it says some men between 75 and 79 who are considered "very healthy" may want to continue screening, especially if their PSA level has been on the rise.
They do not recommend screening for men 80 or older, or for men who are not expected to live another 10 years.
And men diagnosed with prostate cancer that has a low risk of growing or spreading should be offered the option of active surveillance as the initial management option, the guidelines state.
What they're saying:
It is a simple blood test that measures the level of the antigen in the bloodstream, a measure that rises with cancer.
Dr. Robert Smith, the senior vice president of early cancer detection science and the director of the Center for Early Cancer Detection at ACS, says PSA testing is the "cornerstone of detecting prostate cancer early," noting there is now strong evidence of its benefits.
"We also have better approaches to catching lethal tumors while avoiding unnecessary tests for slow-growing cancers that may never need aggressive care," he said.
While he said the PSA test is just the first step in a screening process, secondary testing for men with elevated PSA levels can determine who needs a biopsy and who needs immediate treatment versus those who can be safely monitored.
"These updated guidelines are a critical step toward preventing diagnoses of advanced disease, reducing premature deaths, and minimizing treatment-related harms," he said.
"By making a direct recommendation for men to engage in screening and also advocating for earlier and more frequent screening for Black men, our aim is also to help reduce prostate cancer disparities and ease the disease burden," ACS Chief Scientific Officer Dr. William Dahut said. "Black men experience a 67% higher incidence and nearly double the mortality rate compared with White men, an inequity that needs immediate reversal."
Dig deeper:
Thursday’s release is the first update on screening recommendations since 2010. The timing of the release is significant, since November is recognized as Prostate Cancer Awareness Month.
There is now stronger evidence, the organization says, that PSA test screening "significantly reduces" prostate cancer deaths and diagnosis of advanced-stage disease.
Prostate cancer is one of the most common cancers in me. An estimated 333,830 men will be diagnosed with prostate cancer in 2026, with an estimated 36,320 men dying of the disease.
The Mayo Clinic says prostate cancer symptoms can include:
- Blood in the urine, which may make it discolored.
- Needing to urinate more often.
- Trouble urinating.
- Waking up to urinate more often at night.
What you can do:
The ACS developed a patient page that further explains the new guidelines. Click here for more information on the changes and on prostate cancer.
The Source: Information for this story came from the American Cancer Society, the Mayo Clinic and previous LiveNOW from FOX reporting.