http://www.cancer.org.au/health-professionals/clinical-guidelines/prostate-cancer.htmlThe 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.
Before ordering a PSA test, health practitioners should talk to men about the potential benefits and harms of PSA testing.
In 2012, the Australian Government Department of Health engaged the NHMRC to:
- review the evidence from international screening trials, and other relevant literature, to establish the benefits and adverse effects of using the PSA test to screen for prostate cancer; and
- develop an information document which will guide Australian health professionals in their use of the PSA test.
The independent and expert evaluation of the scientific evidence on PSA testing was undertaken in 2012. With the advice of a purposefully appointed Expert Advisory Group, the review culminated in a report titled PSA testing in asymptomatic men: Evidence Evaluation Report.
A resource for health practitioners was developed based on this evaluation of the evidence and with advice from the Expert Advisory Group.
PSA Testing for Prostate Cancer in Asymptomatic Men: Information for Health Practitioners provides a summary of the evidence on the benefits and harms of PSA testing with or without digital rectal examination for prostate cancer.
Information relating to process of development for the above documents is available in the NHMRC Advice for Health Practitioners on PSA Testing in Asymptomatic Men: Administrative Report. NHMRC invited public comments on the draft Information Document and all submissions were carefully considered. Full submissions are available on the NHMRC Public Consultations website.
- Project Funder: Department of Health
- Project Manager: NHMRC staff
- Expert advice on the Information Document and Evidence Evaluation Report: Expert Advisory Group
- Methodological review of the draft Evidence Evaluation Report: Professor Jenny Doust
- Expert review of the draft Information: Drs Evan Ackerman and Addie Wooten, and Professors Anthony Costello and James Bishop
Clinical Practice Guideline on PSA Testing and early management of prostate cancer
In January 2016, clinical practice guidelines on PSA testing and the management of cancers detected by the test were released by Cancer Council Australia (CCA). CCA developed the Guideline in partnership with the Prostate Cancer Foundation of Australia, with the evidence evaluation from the NHMRC Informant Document contributing to the guideline’s evidence base. These Guidelines provide health professionals with evidence-based recommendations for using the PSA test to assess prostate cancer risk and manage test-detected patients. The recommendations also cover matters such as retesting, active surveillance, watchful waiting and biopsy.
The NHMRC Information Document is referred to in a Good Practice Point in the Guideline: Familiarity with the NHMRC fact sheet ‘PSA testing for prostate cancer in asymptomatic men. Information for health practitioners’, which summarises evidence on the benefits and harms of PSA testing, should help health practitioners to accurately inform men about PSA testing.