The American Cancer Society has updated its prostate screening guidance, and the headline change is a return to PSA blood testing for a wider group of men. For average-risk men, the society now recommends a PSA test every two years starting at age 50. For higher-risk men, the schedule tightens: annual testing beginning at 45. Black men and men with a significant family history of prostate cancer fall into that higher-risk category.
Why PSA is back in favor
PSA screening spent years out of favor, mainly because the test lacks specificity. An elevated PSA level can signal cancer, but it can also reflect benign conditions, which sends some men toward biopsies and anxiety they didn't need. That criticism hasn't disappeared. What changed is the evidence on outcomes. Recent findings show that PSA screening reduced disease-specific mortality for certain men, and that result is what pulled the test back into the guideline conversation. Recent research on the screening question is the foundation for the revision.
The guideline's authors are also looking at a equity problem. Black men are disproportionately represented in prostate cancer deaths, and a persistent pattern is that many of them are diagnosed at advanced stages. The authors hope that earlier and more frequent testing for high-risk groups will catch disease sooner, when treatment options are broader. Whether that happens depends on follow-through: access to testing, insurance coverage, and what happens after an abnormal result. A guideline can set the schedule, but it can't book the appointment.
Senate HELP committee gets a reshuffle
Turning from cancer screening to Capitol Hill, the Senate Health, Education, Labor and Pensions Committee is drawing attention for two reasons. Committee members plan to vote next week on whether to advance Heidi Overton's nomination as commissioner of the Food and Drug Administration. Republicans still hold the majority during this lame-duck session, but Overton's approval isn't assured. A key Republican has not said whether he supports her, and that uncertainty is what makes the vote worth watching.
The committee's leadership is also shifting. Sen. Bernie Sanders (I-Vt.) will chair the panel in January, and he's expected to push the Democratic party toward supporting "Medicare for All." He'll have a new sparring partner. Sen. Rand Paul (R-Ky.) announced that he will give up his chairmanship of the Senate Homeland Security Committee to become the top Republican on HELP next year.
Paul's move matters because of what he did with his current gavel. He used the homeland security panel's unusually strong subpoena power to accuse Anthony Fauci, the former director of the National Institute of Allergy and Infectious Diseases, of conspiring to cover up the origins of the Covid-19 pandemic. Paul offered no evidence for that accusation, according to the reporting. Committee members then voted along party lines to hold Fauci in contempt of Congress. Moving to HELP gives Paul a platform to fight Sanders over Medicare for All and a wide range of other health issues, and the partisan temperature of that committee is likely to rise with him.
The cost of replacing BMI
Body mass index is a flawed obesity measure, yet it remains entrenched across medical systems worldwide. A new study suggests that swapping it out would change the numbers considerably. Researchers applied a framework developed last year, one that offers a different way to understand how weight affects health outcomes, to obesity rates in the United States, the United Kingdom, China, and Spain. Across 844,000 participants, BMI-based obesity missed 6.2% of adults that the new metric captured.
The difference comes from what the new measure looks at. BMI relies on height and weight alone. The alternative accounts for where fat sits in the body, particularly abdominal fat, which is more closely linked to metabolic risk. That's why the shift could matter for mortality risk assessment and not just for headcounts. If millions of diagnoses can flip depending on the metric, clinicians, insurers, and public health officials will have to reckon with what a "case" of obesity actually means. Replacing a metric that's easy to calculate with one that requires more measurement is not a small ask, and the study doesn't pretend otherwise. Further coverage of the study's findings goes deeper into the implications.
What MAHA learned from Black activists, and what it skipped
Two new First Opinion pieces examine how the Make America Healthy Again movement's history shapes its present, and they come at it from opposite directions. In the first, Jerel Ezell argues that MAHA has borrowed strategies from Black environmentalists who have spent decades fighting systemic health and food system failures. His critique is that the movement took the playbook without extending the benefits. "Even as Kennedy and MAHA have cribbed from the Black activist playbook, they've actively undermined" Black Americans, he writes.
In the second, Gavin Yamey takes on the movement's response to Russell Brand, a convicted rapist, whom key MAHA leaders have stood by. Yamey argues that the stance isn't an aberration but reflects a history of cozying up to violent men. "There is a rot of toxic masculinity and violence at MAHA's core," Yamey writes. Read the full piece for his argument.
Pharmacogenes get a more diverse dataset
If you've ever cycled through several doses of the same medication before one worked, your pharmacogenes may be the reason. These genes shape how the body processes prescription drugs, which affects both the right dose and the likelihood of side effects. A new study drawing on nearly 100,000 Americans in the National Institutes of Health's All of Us program has identified thousands of previously unknown variants in these genes. The program's collection of genetic data from diverse backgrounds is a big part of why the study could find them.
The findings are practical. Every participant carried at least one variant across the 16 pharmacogenes the researchers examined. One in four participants had taken a medication that those variants could affect, and the list ranged from selective serotonin reuptake inhibitors to chemotherapy drugs. That's a lot of prescriptions touched by genetic variation most clinicians don't routinely check. Pharmacogenomic testing has been slow to reach routine care, and studies like this one make the case that the gap between the science and the prescribing pad is worth closing. The open question is how quickly research on diverse populations can turn into dosing guidance that works for everyone who takes these drugs.