Prostate Cancer Testing

Current guidelines recommend that:

• All men from the age of 50 years with a life expectancy of at least 10 years should have access to a yearly PSA and DRE
• All men who have a family history of prostate cancer should have access to a yearly PSA and DRE from the age of 40
• Health conscious men from the age of 40 should have access to a baseline PSA to quantify their lifetime risk of prostate cancer and guide the frequency of subsequent testing
• Mass population based prostate cancer screening as a public health initiative by governments is currently not recommended

Testing for prostate cancer, with a PSA blood test and DRE, should only be undertaken after informed discussion with the patient and their treating doctor regarding:

• The current controversies regarding prostate cancer screening and early detection
• The pros and cons of early prostate cancer detection
• The consequences of an abnormal PSA or DRE result
• The potential outcomes and treatments that may occur should prostate cancer be diagnosed

Baseline PSA

There is increasing evidence suggesting a potential benefit for men to have a baseline PSA at the age of 40. A baseline PSA at the age of 40 has the potential to predict an individual’s future risk of developing prostate cancer. It can then guide the frequency of further testing with a PSA and DRE. Individuals indentified as high risk can undergo close monitoring whilst individuals identified as low risk can have less frequent monitoring. It also allows the identification of a small number of aggressive cancers that can be found in young men.