Prostate cancer diagnoses in the United States are climbing again after years of decline, with a troubling rise in advanced-stage cases, according to new data from the American Cancer Society (ACS).
The ACS report, released Tuesday, found that prostate cancer diagnoses increased by 3% annually beginning in 2014, following a decade of steady decreases averaging 6.4% per year. The most concerning trend is in late-stage disease, which has surged by as much as 6.2% annually depending on age group.
At the same time, progress in reducing prostate cancer deaths has slowed. Mortality declined 3% to 4% per year in the 1990s and 2000s but has dropped by just 0.6% annually over the past decade.
Shifts in screening practices
Experts link part of the trend to changes in prostate-specific antigen (PSA) testing. The U.S. Preventive Services Task Force advised against routine PSA screening in the early 2010s, citing concerns about overdiagnosis. Since then, PSA use has declined, even as advanced prostate cancer rates have risen.
“We actually see PSA testing this decade versus the previous decade going down, so the incidence is going up despite less testing occurring,” said Dr. Arif Kamal, oncologist and chief patient officer at the ACS. “It starts to speak to other factors that might be environmental or nutritional or other things that we don’t fully understand.”
While PSA testing can help detect prostate cancer early, overuse may have led to unnecessary treatment. Now, experts worry that reduced screening could be fueling more late-stage diagnoses.
Guidance for men
The ACS advises men 45 and older to discuss prostate cancer screening with their doctors. For some, testing may not be recommended, but for many, a tailored approach offers the best protection.
The organization is also urging federal lawmakers to eliminate cost-sharing for prostate cancer screening among men at higher risk.
Disparities by race
The report highlights stark racial inequities. Prostate cancer death rates are twice as high for Black men compared with any other group. Native American men face a 12% higher mortality rate than White men despite a lower incidence of the disease.
“A one-size-fits-all approach doesn’t work when we know certain populations are at higher risk,” Kamal said. “That knowledge should influence how urgently and how often we test.”
A common diagnosis
Prostate cancer remains the most frequently diagnosed cancer among men in the U.S., accounting for an estimated 30% of male cancers in 2025. It is also the second-leading cause of cancer death in men, behind lung cancer.
Kamal noted that PSA testing discussions can serve as a gateway to broader conversations about men’s health. “Men generally don’t like coming to the doctor, and this gave a focal point to talk about prostate health — but also things beyond that,” he said.
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