New Prostate Cancer Screening Guidelines Unveiled

American Cancer Society now suggests those with PSA of less than 2.5 be tested every two years

By Amanda Gardner
HealthDay Reporter

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WEDNESDAY, March 3 (HealthDay News) -- For the first time in almost a decade, the American Cancer Society has revamped its recommendations for prostate cancer screening.

In new guidelines released Wednesday, the society says that men who choose to be tested should get an annual screening if their level of prostate-specific antigen, or PSA, is 2.5 nanograms per milliliter (ng/mL) or higher. But men whose PSA is under that threshold can be safely screened every two years. Men with a PSA level of 4.0 ng/mL or higher should consider getting further evaluation, such as a biopsy. Previous guidelines had suggested that men with a PSA of less than 4.0 ng/mL should be screened annually.

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While the cancer society does not recommend screening for anyone -- even men at risk -- it does offer suggested intervals for screening if men choose to be tested.

"In the U.S., that I'm aware of, this is the first cancer organization that has recommended screening less often than a year in guidelines," said Kathryn Taylor, an associate professor of oncology at Georgetown University Lombardi Comprehensive Cancer Center in Washington, D.C.

The new guidelines also included specific suggestions on how to encourage shared decision-making such as the use of decision aids, many of which already exist, and specific topics to be discussed. As before, men should start talking about the possibility of screening with their health-care provider at the age of 50 if they are at average risk, and earlier if they are at higher risk.

"We continue to emphasize the importance of informed decision-making, and in this guideline we take it a step further," said Dr. Durado Brooks, director of prostate and colorectal cancer for the American Cancer Society. "For a long time, we have given some very general information about what men should be told. Here we have spent a great deal of time, energy and effort identifying the truly important core elements of that informed decision conversation so men really understand what the uncertainties and questions are surrounding this very complicated issue."

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