CA · Nov 12, 2026

American Cancer Society guideline for the early detection of prostate cancer, 2026

By Hoffman RM, Wolf AMD, Etzioni RD et al.

The goal of prostate cancer screening is to reduce morbidity and mortality through the early detection of clinically significant disease. Accumulating evidence shows that prostate‐specific antigen (PSA)‐based screening significantly reduces prostate cancer mortality and advanced‐stage diagnosis, and approaches to reduce harms associated with screening are increasingly being used. The ACS conducted a systematic review and commissioned a modeling study to evaluate PSA‐based screening strategies, and concluded that the benefits of screening outweigh the harms. Before initiating screening, clinicians should ensure that patients are informed about the benefits, limitations, and harms of screening; the potential follow‐up evaluations of elevated PSA levels; and the expectation that low‐risk cancers will initially be managed with active surveillance. The ACS recommends biennial screening from ages 50‐69 years for average‐risk men (i.e., non‐Black men without a family history of prostate cancer). Annual screening from ages 45‐69 years is recommended for Black men. Annual screening from ages 45–69 years is recommended for non‐Black men with a strong family history (i.e., multiple first‐degree relatives diagnosed with prostate cancer at any age or one diagnosed before age 65 years). Biennial screening from ages 45‐69 years is recommended for non‐Black men with a single first‐degree relative diagnosed at age 65 years or older. For men ages 70–74 years, the balance of benefits and harms is uncertain, and individualized decision making is recommended. The ACS recommends further evaluating men ages 45–69 years with PSA levels ≥3.0 ng/mL and men ages 70–74 years with PSA levels ≥6.5 ng/mL. Most men who have elevated PSA levels confirmed on repeat testing should be offered magnetic resonance imaging and/or a validated biomarker test to guide biopsy decisions. Screening is not recommended for men with a life expectancy <10 years and should be discontinued at age 75 years.

doi.org/10.3322/caac.70112Open accessPubMed 43018083Industry & policy