Prostate Cancer Foundation of Australia has developed national evidence-based clinical practice guidelines on PSA testing and early management of test-detected prostate cancer.
The size of the prostate is often compared to the size of a walnut and we have compiled this guide to the latest thinking in prostate cancer screening.
Prostate cancer is the most common cancer in Australian men with some 24,217 cases diagnosed in 20221 and some 3500 deaths are attributed to prostate cancer in Australia1.
For patients that decide to screen, there are tests that can spot cancer before obvious symptoms occur, including a blood test that detects what’s called a Prostate Specific Antigen (PSA). 2
For healthcare professionals, find out below if it is the right time to chat to patients about the walnut!
Prostate Cancer Foundation of Australia has developed national evidence-based clinical practice guidelines on PSA testing and early management of test-detected prostate cancer.
For men who decide to be tested, it contains guidance on matters such as what age to start testing; how frequently to be tested; when to stop testing; the PSA level which should prompt further investigation; family history; and the role of the digital rectal examination.
By encouraging this dialogue and providing up-to-date medical information, the campaign seeks to raise awareness of the potential protection conferred by prostate cancer screening for at-risk individuals and ensure that PSA testing is accessible to the men most likely to benefit from it.
A raised PSA level in the blood could be a sign of prostate cancer, and patients should be able to speak with their doctor to discuss how to move forward, and whether they require further tests or annual monitoring.2
Annual screening for prostate cancer could reduce the chance of dying from the disease by around 30%4
While earlier diagnosis based on PSA screening may reduce prostate cancer mortality, efforts to maximise mortality reduction can conversely increase the risk of overdiagnosis in prostate cancer. Indeed, PSA screening is not recommended for all men or for use in national screening programmes, but may be relevant for high-risk individuals.5,6,7
PSA results can inform risk assessments for prostate cancer but they cannot categorically identify cancer or rule it out. There are no specific normal or abnormal levels of PSA in the blood and levels can vary between men and even within the same individual.8
Generally, PSA levels above 3 or 4 ng/ml may indicate a need for further evaluation/referral. 8-10 For example, digital rectal examinations also help to inform a diagnosis of prostate cancer, although biopsy is needed for confirmation, and to grade any cancer found using the Gleason score.6,12 Further staging work-up – for example with computed tomography (CT), magnetic resonance imaging (MRI) or transrectal ultrasound – may be warranted.