Testing for prostate cancer using the prostate specific antigen (PSA) test
The prostate specific antigen (PSA) test is a commonly used blood test to detect potential prostate cancer, but elevated PSA levels do not necessarily mean cancer is present.
Advice on use of the PSA test to detect prostate cancer can be conflicting and confusing. On one hand, prostate cancer may be detected at an early stage where treatment may be simpler and more effective. On the other hand, the potential harms of a false test result, overdiagnosis, or overtreatment may outweigh any benefit.
Before ordering a PSA test, health practitioners should talk to men about the potential benefits and harms of PSA testing.
With funding from the Department of Health, NHMRC has developed balanced, evidence-based information for health practitioners to support them in talking to men and their families about the benefits and harms of PSA testing for prostate cancer and of any follow up investigations and treatments.
PSA Testing for Prostate Cancer in Asymptomatic Men: Information for Health Practitioners (the Information Document) provides a summary of the evidence on the benefits and harms of PSA testing, with or without digital rectal examination (DRE), for prostate cancer in asymptomatic men.
The Information Document and the underlying evidence base are available on the NHMRC website under Prostate-Specific Antigen (PSA) testing in asymptomatic men.
- NHMRC Media Release: Resource for Health Practitioners: Prostate Specific Antigen (PSA) testing in asymptomatic men - 4 March 2014
- NHMRC Media Release: NHMRC welcomes feedback on prostate cancer resource for health practitioners - 22 July 2013
- NHMRC Media Release: Should I be tested for prostate cancer? - 31 August 2012
PSA Testing Expert Advisory Group
An Expert Advisory Group was established to advise on the development of the Information Document including the underpinning evaluation of the evidence.
The PSA Testing Expert Advisory Group comprised experts across Australia. The disciplines represented included general practice, medical oncology, urology, pathology, public health, epidemiology, Aboriginal and rural health, and evidence-based practice. Consumers were also represented.
Related Work on PSA Testing
Clinical Practice Guidelines in Development
The Information Document is not a clinical practice guideline and does not make clinical practice recommendations. The Prostate Cancer Foundation of Australia (PCFA) and Cancer Council Australia (CCA) are currently developing clinical practice guidelines for PSA testing and management of test-detected prostate cancer (NHMRC Guidelines Register). These guidelines will supplement NHMRC’s work by providing further clinical guidance for doctors consulting with men about having a PSA test. PCFA-CCA’s guidelines will be developed using the NHMRC procedures and requirements to meet the 2011 NHMRC standard for clinical practice guidelines (the 2011 NHMRC Standard). The guidelines are estimated to be completed in December 2014.
Prostate cancer screening in Australia
Use of the PSA test to identify an individual’s risk of prostate cancer is not the same as population-based screening. Population-based screening is where a test is offered to all individuals in a target group, often defined by age, as part of an organised program.
The purpose of the Information Document is to assist General Practitioners and other health practitioners provide consistent, evidence-based advice to asymptomatic men who are considering undergoing a PSA test. It is not designed to provide population level advice.
Australia’s current position on population screening for prostate cancer is available on the Australian Government Cancer Screening website.