Prostate cancer often doesn’t cause symptoms in its early stages. So how can you find it before it becomes more difficult to treat? For many men, the answer starts with a simple blood test, and new guidelines spell out when to get it.

The American Cancer Society has released its first new prostate cancer screening guidelines since 2010, recommending regular PSA testing for men ages 50 to 69 at average risk, and earlier, more frequent screening for some men who are at higher risk for prostate cancer.

Here are some of the key changes:

• The new guidelines recommend that men at average risk for prostate cancer should be screened with a prostate-specific antigen (PSA) blood test every two years from ages 50 to 69, after a conversation with their doctor. Comparatively, previous guidelines did not recommend a specific screening schedule — instead, they recommended talking with your doctor and making a shared decision about whether to screen.

• Men ages 45 to 69 at higher risk for prostate cancer — including men with a strong family history of prostate cancer and Black men — should be screened annually, using a PSA blood test. (Keep reading for more details on family history.)

• Men ages 70 to 74 can continue shared decision-making with their doctor by discussing the balance of potential benefits and harms. Screening is not recommended for most men ages 75 and older.

• The guidelines also recommend secondary diagnostic tests — including an MRI and/or biomarker testing — in men who have an elevated PSA, as shown on a repeat PSA test. This secondary testing can determine whether a more invasive prostate biopsy is necessary.

Dr. Adam Kuykendal, a medical oncologist and hematologist at Novant Health Cancer Institute - Matthews, called the new guidelines “important to raise awareness and improve men's health going forward.”

“The American Cancer Society is getting important information that we have learned with new research and advances in diagnosis and management out to the public to help more men detect and manage prostate cancer,” he said.

For more on prostate cancer, what a PSA test actually measures and why screening stops at a certain age, keep reading.

What is prostate cancer?

The prostate is a small gland located just below the bladder. It creates a fluid that nourishes sperm and helps it travel during ejaculation.

Prostate cancer happens when there’s abnormal cell growth in the prostate gland, although not all abnormal growths are cancer. Typically, prostate cancer grows slowly — but this isn’t always the case.

How common is prostate cancer?

Apart from skin cancer, prostate cancer is the most common cancer among men and is the second leading cause of cancer death among men in the U.S. Here’s one way to think about it: Out of 100 U.S. men, roughly 13 will get prostate cancer at some point during their lifetime, and two to three of the 100 will die from it.

Compared with other men, Black men are more likely to get prostate cancer. They’re also more likely to get prostate cancer at a younger age, find it at a more advanced stage and to die from it. That’s why the new guidelines specifically address Black men.

Having a strong family history of prostate cancer also increases the risk of prostate cancer. The new guidelines classify a strong family history as having multiple first-degree relatives who were diagnosed with prostate cancer at any age, or having one first-degree relative who was diagnosed before the age of 65.

What are the symptoms of prostate cancer?

Many men with prostate cancer don't experience any symptoms, especially in the early stages. This is why regular screening is recommended — so your doctor can find and address prostate cancer before it becomes advanced.

As prostate cancer becomes more advanced, symptoms could include difficulty with urination, blood in urine or semen, pain and loss of appetite or weight. Prostate cancer can eventually spread to other parts of the body.

What is a PSA test and what does it measure?

A PSA test is a blood test that measures a protein called prostate-specific antigen that is produced inside the prostate and enters the bloodstream.

PSA levels can rise in the bloodstream when prostate cancer is present. But a high PSA doesn't necessarily mean you have cancer. Other prostate conditions can raise it, too, which is why an abnormal result leads to additional diagnostic testing rather than an immediate biopsy. One elevated PSA level does not mean you have cancer.

Your doctor will interpret your PSA blood test results based on your age, the amount of PSA in your blood, any past PSA tests you’ve had, medications you’re taking, factors like your race/ethnicity and any previous prostate conditions you’ve had.

What does it mean if my PSA level is elevated?

If your PSA level is abnormally elevated (as defined by the guidelines), the guidelines recommend taking a repeat PSA test two weeks to three months after the first. If the second PSA level remains elevated, the new guidelines recommend that your doctor order secondary tests, such as biomarker testing and/or an MRI, to determine whether you need a biopsy.

A biopsy is the only way to confirm whether the tissue in the prostate is cancerous. But it can be painful and typically requires local anesthesia.

The guidelines aim to prevent unnecessary biopsies while making sure that those at risk for prostate cancer are still evaluated.

Why does prostate cancer screening stop for men age 75 and older?

Many prostate cancers are what doctors consider low-risk prostate cancers that are slow-growing and unlikely to cause problems for older men. In these cases, patients often choose “active surveillance,” which means they monitor the cancer but don’t treat it unless it starts to grow faster.

Doctors want to be careful not to over-diagnose and overtreat low-risk prostate cancer because treatments like surgery and radiation can come with side effects. The new guidelines say that patients should be informed before their screening is stopped, and that doctors should discuss why.

What is a screening guideline?

A screening guideline is designed to help doctors and patients decide whether, how and how often to screen for a disease. It uses evidence to weigh the benefits of screening — such as detecting cancer while it is still treatable — against the possible harms of screening, like false positives and unnecessary follow-up procedures.

Since 1980, the American Cancer Society has issued guidelines about screening for specific cancers. The 2026 guidelines for prostate cancer screening were created by volunteers in a Guideline Development Group that included doctors, biostatisticians, epidemiologists, health researchers and patient representatives.

Why did the prostate cancer screening guidelines change?

In 2010, scientists weren’t clear about whether there was long-term benefit from PSA-based screening. Now, the Guideline Development Group believes there is stronger evidence that screening lowers a man’s risk of dying from prostate cancer. Compared to 2010, there are also better tools to reduce some of the harms of screening. This prompted the guideline update.

The takeaway: The American Cancer Society updated its guidelines because stronger evidence shows PSA screening reduces prostate cancer deaths and advanced-stage diagnoses. There are tools to help you avoid unnecessary biopsies and treatment. Talk with your doctor to find out when you should start prostate cancer screening.