In 2009, the American Cancer Society (ACS) initiated a series of systematic evidence reviews to update recommendations for early prostate cancer detection. The evidence reviews focused on studies of screening, the performance of screening tests, harms associated with testing and therapy for localized prostate cancer, and shared and informed decision making in prostate cancer screening. Based on this evidence, the ACS recommends that asymptomatic men who have at least a 10-year life expectancy have an opportunity to make an informed decision with their health care provider about screening for prostate cancer after receiving information about the uncertainties, risks, and potential benefits associated with prostate cancer screening. Prostate cancer screening should not occur without an informed decision-making process. Men at average risk should receive this information beginning at age 50. Men in higher-risk groups should receive this information before age 50. Men should either receive this information directly from their health care providers or be referred to reliable and culturally appropriate sources. Patient decision aids are helpful in preparing men to make a decision whether to be tested, and the use of such aids is encouraged.