American Cancer Society Updates Prostate Cancer Screening Guidelines

For the first time, the American Cancer Society is recommending routine prostate cancer screenings. The medical group says that blood tests, especially for those at high risk, like Black men and those with a family history, would save lives. NPR’s Yuki Noguchi reports.

YUKI NOGUCHI, BYLINE: For years, University of Virginia cancer prevention expert Andrew Wolf says the cost benefit of prostate screening has not been clear. It’s long been known that PSA, or prostate-specific antigen, blood tests measuring cancer biomarkers help detect tumors before they spread.

ANDREW WOLF: But the benefit was relatively small, and the potential harms from screening were relatively large, so that the balance was uncertain for a long time.

NOGUCHI: That’s because most prostate cancers, which are diagnosed in over 300,000 Americans a year, tend to grow slowly. Many may never grow enough to do harm. So there was also a risk of overtreatment, says Wolf, who’s on the American Cancer Society’s Guideline Development Committee and coauthored the new recommendations. Unnecessary biopsies and surgeries come with serious downsides.

WOLF: Sexual dysfunction, urinary incontinence, and if we’re not positive that early intervention is beneficial, then those harms are significant.

NOGUCHI: So until now, the American Cancer Society urged patients to consult with their doctors to decide whether to undergo screening. That remains the guideline endorsed by the influential U.S. Preventive Services Task Force today, a group made up of federally appointed experts. But the Cancer Society’s new recommendation is for men aged 50 to 69 and at average risk for the disease to screen every other year. For those at higher risk, Black men and those with family history of the disease, Wolf says the new guideline is to screen annually, starting at age 45.

WOLF: The bottom line is it has been shown to reduce the risk of dying from prostate cancer.

NOGUCHI: The new guidelines also reflect new ways to avoid overtreatment – MRI imaging or additional blood tests prior to biopsy, for example. It does not recommend screening for those 75 and older unless previous PSA tests came back elevated.

Yuki Noguchi, NPR News.