The American Cancer Society issued updated clinical guidance on November 12, 2026, directly recommending routine prostate-specific antigen blood testing every two years for average-risk American men ages 50 to 69. For individuals facing elevated risk, specifically Black men and those with a significant family history of prostate cancer, the guidelines advise beginning annual PSA screening at age 45.
More than 300,000 men in the United States are projected to receive a prostate cancer diagnosis this year, and roughly 36,000 will die from the disease, with Black men dying at twice the rate of white men. "PSA testing remains the cornerstone of detecting prostate cancer early, and we now have stronger evidence of its benefits," said Dr. Robert Smith, senior vice president of early cancer detection science at the American Cancer Society.
Screening Cutoffs and Diagnostic Sequence
The updated protocol establishes an elevated PSA threshold of 3.0 nanograms per milliliter or higher for men aged 45 to 69, and 6.5 nanograms per milliliter or higher for those aged 70 to 74. If an initial reading crosses that mark, the guidance requires a confirmatory PSA test between two weeks and three months later, followed by an MRI scan or biomarker testing, before a biopsy is considered.
"Our goals are to decrease the risk of men being diagnosed with metastatic prostate cancer and dying from the disease, and at the same time minimizing harm," said Dr. William Dahut, chief scientific officer at the American Cancer Society. When clinicians identify low-risk, slow-growing tumors, the guidelines advocate active surveillance as the primary initial approach instead of immediate medical intervention.
Age Limits and Insurance Considerations
The new stance marks a shift from the society's 2010 guidance, which did not recommend routine population screening and advised men to make individual decisions after discussing risks with physicians. For men aged 70 to 74, testing decisions remain individualized because the balance between benefits and harms is less clear, while screening should stop for men age 75 and older or anyone with a life expectancy under 10 years.
Federal guidance from the U.S. Preventive Services Task Force still advises against routine population-wide screening, leaving testing to individual doctor-patient consultation while it completes an update.
