Key Takeaway: The American Cancer Society’s 2026 guideline recommends prostate cancer screening every two years for men at average risk, beginning at age 50, and every year for higher-risk men, particularly Black men, beginning at age 45. Men should discuss their screening schedule with their healthcare provider based on their age and risk factors.
Prostate cancer is the most common malignancy in men, making up approximately 30 percent of all male cancer cases in the United States. The American Cancer Society (ACS) estimates that 333,830 men in the U.S. will be diagnosed with prostate cancer in 2026 and 36,320 will die from the disease.
Prostate cancer screening is an important tool for detecting cancer early, when treatment may be more effective and before the disease has a chance to spread. Regular screening can help improve early detection, treatment outcomes and survival rates for prostate cancer patients.
Updated guidance from the American Cancer Society has changed when, and how often, many men should be screened. Here is what is new and what it means for you.
What Changed in the ACS Guideline?
In November 2026, the American Cancer Society updated its prostate cancer screening guideline for the first time since 2010. Screening primarily uses a blood test to measure prostate-specific antigen (PSA), a protein made by the prostate gland. An elevated PSA level can be a sign of cancer, but it can also have other causes.
The new guideline recommends regular PSA-based screening for men at average and higher risk, reflecting stronger evidence that screening can reduce deaths from prostate cancer and diagnoses of advanced disease.
Several factors shaped the update. A large European randomized trial with more than 20 years of follow-up found that PSA screening lowered prostate cancer deaths. At the same time, ACS research has found that diagnoses have been rising, including cases of advanced (metastatic) disease in men 55 and older.
Determining Your Risk Factor for Prostate Issues
Certain risk factors are known to increase the chances of a man developing prostate cancer. They include:
- Advancing age
- Having a family history of prostate cancer, especially if a close relative (father or brother) was diagnosed at a younger age (before 65)
- Race, black men have a higher risk of developing prostate cancer
- Inherited gene changes, including mutations in BRCA1 and BRCA2, which can increase prostate cancer risk
- Obesity, poor diet and lack of physical activity
- History of certain prostate conditions or chronic inflammation of the prostate (prostatitis)
- Environmental toxin exposure
- Smoking history within 10 years of screening/diagnosis
Men approaching age 45, particularly those with a family history of prostate cancer, should discuss their risk and screening options with a healthcare provider or urologist.
When Should You Get Screened for Prostate Cancer?
Below are the American Cancer Society’s current recommendations for who should be screened with a PSA blood test, and when.
- Average risk (ages 50-69): Men at average risk should have a PSA test every two years, beginning at age 50.
- Higher risk (starting at age 45): The ACS recommends annual PSA screening beginning at age 45 to 69 for Black men. The same recommendation applies to men whose father or brother was diagnosed before age 65 or who have multiple close relatives with prostate cancer.
- Men with one first-degree relative diagnosed at age 65 or older: Non-Black men in this group should begin PSA screening at age 45 and have a test every two years through age 69.
- Ages 70-74: Men in this age group should discuss the benefits and risks of continued PSA screening with their physician. The decision should take into account their overall health and life expectancy.
- Age 75 and older: PSA screening is not recommended for most men in this age group. Prostate cancer often grows slowly, and a PSA test may find small cancers that would never cause problems during a man’s lifetime. Finding these cancers can lead to biopsies and treatment with side effects, without helping him live longer. However, some very healthy men ages 75 to 79 may choose to continue screening. They should discuss the potential benefits and risks with their doctor.
What Happens During Prostate Cancer Screening
The primary screening method for prostate cancer is a prostate-specific antigen (PSA) blood test.
- Prostate Specific Antigen (PSA) blood test: This test measures the level of PSA in the blood. Elevated PSA levels can indicate various prostate conditions, including prostate cancer. Because PSA can also be raised by non-cancerous conditions, a high result does not necessarily mean cancer.
- Digital Rectal Exam (DRE): During this physical examination, a healthcare provider inserts a gloved, lubricated finger into the rectum to feel the prostate for changes in size, shape or texture. A doctor may also perform a digital rectal exam (DRE) to evaluate a specific prostate concern, however the 2026 ACS guideline does not recommend DRE as part of a routine screening test.
What Are They Testing for During Screening?
The primary goal of screening is to detect prostate cancer in its early stages. An abnormal PSA level or findings during a DRE can signal that additional tests are needed to confirm or rule out cancer.
Under the updated ACS guideline, an elevated PSA should be followed by a repeat PSA test and a prostate MRI before a biopsy is scheduled. This approach helps avoid biopsies that may not be needed.
What Happens After Screening?
- Screening Results: PSA test and DRE results are usually available within three weeks and help guide doctors in developing personalized recommendations.
- High-Risk Cases: Patients identified as high-risk or with abnormal findings are typically scheduled for further evaluation with urologic oncology specialists. An abnormal finding doesn’t necessarily mean that cancer is present; it’s considered a sign that more testing is needed to determine someone’s risk of prostate problems.
- Normal Results: Follow-up visits or continued monitoring plans are tailored to each patient’s health needs and risk profile. Men at average risk are generally advised to repeat PSA screening every two years, and men at higher risk annually.
- Prostate Cancer Diagnosis: If prostate cancer is diagnosed, patients receive comprehensive care from a multidisciplinary team. This includes specialists in urologic oncology, radiation oncology and medical oncology, ensuring appropriate diagnosis, staging, and treatment.
Understanding the Benefits and Risks of PSA Screening
PSA screening can help detect prostate cancer early, when it may be easier to treat. The decision to get screened should take into account a man’s age, risk factors, overall health and personal preferences. Talk with your healthcare provider about when to begin screening and how often to be tested based on your individual risk.
*Originally published September 26, 2025. Updated November 2026.
For more information on prostate exams and scheduling your screening, visit Stony Brook Medicine’s Department of Urology.
Stony Brook Urology’s Prostate Cancer Program offers free screenings throughout the year at various locations across Suffolk County as part of our long-standing commitment to serving at-risk individuals. No insurance is required. Learn more or call (631) 216-9181.
The Stony Brook Cancer Center offers a full spectrum of prostate cancer care, including advanced diagnostics and treatment from a multidisciplinary team of experts. For more information, call (631) 638-1000.
