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What men need to know after a major update to prostate cancer guidelines
The American Cancer Society now recommends regular prostate cancer screening for men at average risk, a change from its previous advice to discuss testing with a doctor. The update reflects evidence that screening can help detect cancer before it spreads, alongside measures to reduce unnecessary tests and treatment.
Men at average risk should have a PSA blood test every two years from ages 50 to 69. Men at higher risk, including Black men and those with close relatives diagnosed before age 65, should start annual checks at 45; men with one close relative diagnosed after 65 should also start at 45, but test every two years. Screening is generally not advised when a person is unlikely to live another 10 years; men should discuss the choice at 70, and screening is discouraged from age 80.
In short
- Average-risk men should have PSA tests every two years from 50 to 69.
- Higher-risk men should start checks at 45, usually every year.
- Doctors can use repeat tests and MRI to help reduce screening harms.
Steelman: both sides, in good faith
The strongest fair case each way — we don't pick a winner.
The case for
Regular PSA screening could find prostate cancer before it spreads, when treatment may be more effective and the risk of death lower. Routine checks, especially for men at higher risk, may also make access less dependent on whether someone knows to raise screening with a doctor.
The case against
PSA screening can lead to false alarms, follow-up procedures and treatment for cancers that would never have caused harm, bringing anxiety and possible lasting side effects. A more cautious approach, based on an informed discussion with a doctor, may help men weigh those risks against their personal risk and life expectancy.
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