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In reversal, American Cancer Society urges prostate cancer tests for all men
The American Cancer Society now recommends routine PSA screening for men, reversing its 2010 guidance, which left the decision to men and their doctors. It says newer evidence suggests screening can save lives, while improved ways to assess and manage cancer can reduce harms from unnecessary diagnosis and treatment.
Men at average risk are advised to test every two years from ages 50 to 69. Black men and certain men with a family history should start at 45, with testing yearly for most; men aged 70 to 74 should discuss screening with a doctor, and screening is not recommended from age 75. The guidance calls for repeating a high PSA result before further assessment, using MRI or a biomarker test if it remains high, and favouring active surveillance for low-risk cancers. The ACS estimates nearly 334,000 US men will be diagnosed in 2026 and more than 36,320 will die.
In short
- The ACS recommends routine PSA screening for men.
- Average-risk men should test every two years from 50 to 69.
- New safeguards aim to limit unnecessary biopsies and treatment.
Steelman: both sides, in good faith
The strongest fair case each way — we don't pick a winner.
The case for
Routine PSA screening could catch aggressive prostate cancers earlier, when treatment may be more effective, and newer diagnostic tools and active surveillance may limit unnecessary biopsies and treatment. A clear recommendation may also help men and clinicians make informed choices, particularly for groups at higher risk of dying from the disease.
The case against
Screening can produce false alarms and detect slow-growing cancers that would never cause harm, leading to anxiety, further tests and potentially lasting treatment side effects. Even with improved follow-up methods, the benefits may not outweigh these harms for every man, so decisions tailored to individual risk and preferences may be preferable to routine testing.
Explained simply
The prostate is a small gland below the bladder. Prostate cancer occurs when cells in the gland grow abnormally, and it is one of the most common cancers among men. Some cancers grow slowly and may never cause serious illness, while others can spread and become life-threatening.
The PSA test measures a protein in the blood that can be raised by prostate cancer, but also by other conditions. A high result does not by itself show that someone has cancer, and screening can lead to further tests or treatment for cancers that would not have caused harm. These trade-offs have shaped debate over when testing is useful.
The American Cancer Society is a US health organisation that issues cancer-screening guidance. Its recommendations are intended to help men and doctors weigh possible benefits and harms, including how to follow up a raised PSA result and how to manage a cancer found through screening.
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