The U.S. is now urging middle-aged men to routinely screen for prostate cancer. What about Canada?

Detailed summary

Middle-aged men should undergo regular screening for prostate cancer, the American Cancer Society said Thursday in a major change to U.S. guidelines.

The screening involves a simple blood test, and men at average risk of getting prostate cancer should get that PSA test every two years between the ages of 50 and 69, the society advised.

Men at high risk, including Black men and those with a strong family history of prostate cancer, should get yearly PSA checks and start earlier, at age 45, it said.

Thursday's guideline update marks a shift in thinking in the U.S. about routine blood tests for PSA, or prostate-specific antigen.

Since 2010, the American Cancer Society has recommended that men at average risk talk with their doctors about whether to get regular PSA tests.

The tests look for a protein produced by both normal and cancerous prostate cells, meaning a high level might signal a tumour, but also could be from a benign enlarged prostate or be a temporary spike from vigorous exercise.

Widespread PSA testing in the past was blamed for overtreatment of slow-growing tumours and unnecessary followup testing in men who turned out to not have cancer.

The updated advice in the U.S. comes after advances in understanding PSA's benefits and how to reduce potential harms, according to the cancer society. This includes steps such as repeating a PSA test to be sure it's really high or adding an MRI scan to help identify who needs a biopsy.

In Canada, guidelines for prostate cancer screening vary by province and organization, but official guidelines for clinicians from Canada's national advisory body haven't been updated since 2014 — something the Canadian Cancer Society has flagged as a serious issue.

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