New advice from the American Cancer Society puts a sharper focus on the risks of prostate cancer screening, emphasizing that annual testing can lead to unnecessary biopsies and treatments that do more harm than good.

The cancer society has not recommended routine screening for most men since the mid-1990s, and that is not changing. But its new advice goes farther to warn of the limitations of the PSA blood test that millions of American men get now. It also says digital rectal exams should be an option rather than part of a standard screening.

American men have long been urged to have prostate cancer screenings, but over time studies have suggested that most cancers found are so slow-growing that most men could have avoided treatment. The Atlanta-based cancer society is perhaps the most influential group in giving screening advice. Its new guidance released Wednesday on prostate cancer urges doctors to:

-Discuss the pros and cons of testing with their patients, including giving them written information or videos that discuss the likelihood of false test results and the side effects of treatment.
-Stop giving the rectal exam as a standard prostate cancer screening because it has not clearly shown a benefit, though it can remain an option.
-Use past PSA readings to determine how often follow-up tests are needed and to guide conversations about treatment.