News

21-01-2016

The NHMRC (Australia's leading expert body for developing health advice for the Australian community) has just approved Australia's first clinical practice guidelines for prostate testing.  The aim is to provide guidance regarding information for men about the risks and benefits of testing. The guidelines have been developed between the Cancer Council and the Prostate Cancer Foundation Australia and a multi-disciplinary panel of urologists, epidemiologists, radiation oncologists, general practitioners, allied health providers and consumers.  The Guidelines provide recommendations about prostate cancer risk assessment, surveillance and treatment. They also cover retesting, active surveillance, watchful waiting and biopsy.

The Guidelines do not recommend a population screening programme for prostate cancer, but men should weigh up the potential benefits and risks for themselves with their GP

The main recommendations are:

  • Digital rectal examinations are not recommended for asymptomatic men as a routine addition to PSA testing in general practice settings. On referral to a Specialist however, the digital rectal examination is an important procedure in assessing for a management plan
  • Men who are considering having a PSA test require information about the benefits and harms of testing
  • A PSA test decision aid for use by men and their doctors is under development
  • Men who are at average risk of prostate cancer, who are aware of the benefits and harms of testing can be offered PSA testing every 2 years from the age of 50 to 69 years Further investigation should be taken if the level is above 3ng/mL.
  • Men who are older than 70 years of age should be advised should be aware that the harms of continuing or commencing PSA testing may be greater than the benefits of testing men their age
  • Men who have a father or brother who have been diagnosed with prostate cancer have 2.5 - 3 times higher than average risk of developing the disease. Such men who are aware of the benefits and harms of testing, who decide to undergo regular testing for prostate cancer, should be offered PSA testing every 2 years from the age of 45 years to 69 years
  • Men who have a father and two or more brothers who have been diagnosed with prostate cancer have a 9 - 10 times higher than average risk of developing the disease. After advice regarding the benefits and harms of screening, those who decide to undergo screening should be offered PSA testing every 2 years from the age of 40 years to 69 years.
  • Benefits from early diagnosis due to PSA testing regarding reduced mortality is not seen until 6-7 years. PSA testing is not recommended for men unlikely to live another 7 years (subject to health status)

The full Guidelines and simple outlines regarding the statistical benefits and risks can be found at pcfa.org.au (Prostate Cancer Foundation of Australia) or wiki.cancer.org.au (Cancer Council Australia)

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