ACS urges PSA tests every two years for men 50 to 69

Prostate cancer screening rules changed for men in Bexar County this week. The American Cancer Society now recommends that most men between 50 and 69 get a PSA blood test every two years. Men who face higher risks should get the test every year.

The annual testing group includes Black men and men who had a parent or brother diagnosed with prostate cancer before age 65. Men with multiple close relatives diagnosed at any age also fall into this high-risk category. For men aged 70 to 74, doctors should discuss testing based on overall health and life expectancy.

Prostate cancer remains the second leading cause of cancer death among men, following lung cancer. Dr. William L. Dahut, the ACS chief scientific officer, said the new guidelines aim to find cancer earlier. He hopes this will reduce metastatic cases and deaths while limiting treatment side effects.

The shift comes as advanced cases rise. An ACS study found diagnoses increased by about 3% annually from 2014 to 2021. Metastatic cases in men 55 and older grew by roughly 6% each year over that same decade. While death rates from prostate cancer have halved over three decades, that decline has slowed for men aged 55 to 69.

The FDA approved the PSA test for monitoring in 1986. Widespread use then led to a drop in advanced diagnoses. However, concerns about overdiagnosis led the U.S. Preventive Services Task Force to advise against routine testing in 2012. Later data suggested fewer tests may have contributed to the recent rise in late-stage diagnoses.

Early detection allows for surgery or radiation, which improves survival. Only about one in three men with advanced prostate cancer survives five years. The PSA test can sometimes identify cancers that may not be life-threatening, leading to unnecessary treatments. Side effects of treatment can include urinary incontinence and sexual dysfunction.

Former President Joe Biden, 83, announced last year that he has aggressive metastatic prostate cancer. He said his doctors remain encouraged by his response to treatment. Biden stated the cancer has not stopped him but sometimes slows him down. He plans to limit book promotion for his memoir, Promise Me, America, which publishes on November 17.