What Men Over 50 Need to Know About the New Prostate Cancer Screening Guidelines

The American Cancer Society has released new guidelines for prostate cancer screening.

After 16 years of recommending that average-risk men work with their doctors to decide whether or not to screen for prostate cancer, the ACS has largely reversed its guidance.

According to a new report from the ACS on Thursday, November 12, men ages 50 to 69 with an average risk for the disease are now recommended blood tests, called prostate-specific antigen (PSA) tests, every two years. Black men, meanwhile, or men with a family history of prostate cancer, are recommended to start annual testing at age 45.

Where the guidelines begin to vary is when it comes to average-risk men over 70, with the ACS advising they consult with their physician and recommending against screening altogether for men over 75.

According to the Mayo Clinic, most men with prostate cancer get diagnosed during an early stage, and many are cured. But over 36,000 people will die from prostate cancer this year, the American Cancer Society notes, with a vast majority from metastatic, advanced cancer, similar to what former President Joe Biden was diagnosed with. It is the second leading cause of cancer death in men in the US, behind lung cancer, the ACS reports.

Biden, 83, meanwhile, fell into that over-75 group when he got his diagnosis in May 2025. When asked in a new People interview published November 11, if he felt he should’ve gotten tested given his political position, the former commander in chief said: “Look … I had some discomfort, and Jill thought, ‘Why isn’t that test done for men who are in their 70s?’ And there wasn’t any particular [sign] except recurring pain.”

These new guidelines are a significant departure from ACS’s 2010 advice for men over 50, with new research showing that PSA testing can save lives by detecting cancer earlier.

The screening starts with a simple blood test that measures levels of prostate-specific antigen (PSA), the ACS notes. While small amounts of the protein are normal in healthy men, higher levels could signal prostate cancer or other conditions, such as an enlarged or inflamed prostate.

However, high PSA levels do not necessarily mean someone has cancer. The ACS recommends repeating the test within two weeks to three months to see if levels remain elevated. If a second test also shows high levels, doctors may recommend an MRI and/or additional blood or urine tests to determine whether a biopsy is needed.

A biopsy is the only way to confirm a prostate cancer diagnosis. However, men diagnosed with low-risk cancer that is unlikely to grow or spread may be offered active monitoring of the disease as opposed to immediately starting treatment.

“PSA testing remains the cornerstone of detecting prostate cancer early, and we now have stronger evidence of its benefits,” Dr. Robert Smith said in the ACS statement. “We also have better approaches to catching lethal tumors while avoiding unnecessary tests for slow-growing cancers that may never need aggressive care.”