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The American Cancer Society is recommending regular prostate cancer screening starting at age 50 for men at average risk under updated guidelines released Nov. 12.
The update shifts from emphasizing individual decisions about screening to explicitly recommending regular testing for eligible men.
The new guidelines call for PSA testing every two years for average-risk men ages 50 through 69. Black men should begin annual screening at 45, regardless of family history. Other men with a father, brother or son diagnosed with prostate cancer should also begin at 45, with the frequency depending on their family history.
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Men ages 70 to 74 should discuss whether to continue screening with their doctors; routine screening is not recommended at 75 and older.
The American Cancer Society is recommending regular prostate cancer screening starting at age 50 for men at average risk under updated guidelines released Nov. 12. (iStock)
Prostate cancer is the second-leading cause of cancer death among U.S. men. For disease that has not spread beyond the prostate or nearby areas, the five-year relative survival rate is nearly 100%, according to the American Cancer Society.
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“Men think it is going to happen to someone else,” Dr. Ash Tewari, chair of the Milton and Carroll Petrie Department of Urology at the Icahn School of Medicine at Mount Sinai Medical Center in New York City, told .
The doctor, who has performed more than 10,000 prostate cancer operations, said the success rate of treating patients is exceedingly high, but that many men still need to be nudged to get screened.
The new guidelines call for PSA testing every two years for average-risk men ages 50 through 69. (iStock)
A prostate cancer screening involves a simple blood test for PSA, which measures the level of prostate-specific antigen, the protein produced by normal and cancerous cells in the prostate gland.
Under the updated guidelines, a PSA level of 3 ng/mL or higher in men younger than 70 warrants a repeat test to confirm the result. There are other explanations for higher PSA levels beyond the existence of prostate cancer, such as an enlarged prostate, inflammation or an infection.
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Screening can also identify slow-growing cancers that may never cause harm. The society recommends discussing screening’s benefits and possible harms with a healthcare provider and offering close monitoring as an initial approach for low-risk cancers.
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“We know how to cure 95% of them,” said Tewari, referring to prostate cancer patients. “I can operate, we have developed medications … to get to them in time, my approach is very simple: Go right where they are.”
To reach more men, Tewari and Mount Sinai have created mobile prostate cancer screening vehicles that are deployed in neighborhoods so men can be examined where they live.
The society recommends discussing screening’s benefits and possible harms with a healthcare provider and offering close monitoring as an initial approach for low-risk cancers. (iStock)
The first bus, the Mount Sinai Robert F. Smith Mobile Prostate Cancer Screening Unit, was sent out in New York City in 2022. Last month, another bus was deployed to the Atlanta Falcons-Chicago Bears game at Mercedes-Benz Stadium in Atlanta. The Winship Cancer Institute at Emory University offered free screenings in partnership with the Atlanta Falcons during the game.
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Tewari and Mount Sinai are engaged in other ways to get the word out to men.
The ACS estimates that more than 333,000 men in the U.S. will be diagnosed in 2026, and about 36,000 will die from the disease.
Last month, actress Brooke Shields joined Tewari and directed a public service announcement advocating screening and early detection. The goal is to screen more than one million men for prostate cancer under Tewari’s Million Strong Men Initiative.
“We need to be able to talk about …down there,” a son says to his father in the PSA video.
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“I never got to have the talk with my dad early enough,” says Shields in the video. Her father, Frank, died of prostate cancer in 2003 at 61 years old.
“Prostate cancer is treatable when detected early,” she adds.
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“Prostate cancer is often a disease that families don’t talk about until there is a reason to,” said Tewari. “We want to change that. Starting the conversation early can give men an opportunity to learn about their risk, talk with their doctors about screening and act when appropriate.”
Prostate cancer is one of the most common cancers in men. The ACS estimates that more than 333,000 men in the U.S. will be diagnosed in 2026, and about 36,000 will die from the disease.
