For the first time, health professionals have access to evidence-based recommendations for using the prostate specific antigen (PSA) blood test to assess prostate cancer risk and manage test-detected patients.
The guidelines provide evidence-based recommendations to health professionals involved in localised prostate cancer risk assessment, surveillance and treatment. The recommendations also cover matters such as retesting, active surveillance, watchful waiting and biopsy.
The guidelines, PSA Testing and Early Management of Test-detected Prostate Cancer: Guidelines for health professionals, were launched in draft form for consultation more than a year ago. The recommendations have now been approved by the National Health and Medical Research Council (NHMRC).
The guidelines aim to help healthcare professionals navigate the daily professional dilemma of informing men about the risks and benefits of testing, and prevent scenarios where PSA tests are conducted without patient consent. They have been developed through a partnership between Prostate Cancer Foundation of Australia (PCFA) and Cancer Council Australia.
PCFA Chief Executive Officer, Associate Professor Anthony Lowe, said while the PSA test was not suited for population screening, it remained in widespread use, so there was a need for evidence-based guidelines to maximise the benefits of the test and minimise the harms.
“The recommendations were developed following a systematic review of the evidence and consensus on its interpretation by a leading team of epidemiologists, urologists, GPs, radiation oncologists, medical oncologists, allied health professionals and consumers.”
The NHMRC’s Information Document for health professionals, recommended as a companion document to the guidelines, estimates that for every 1000 men aged 60 with no first-degree relatives affected by prostate cancer who take the test annually for ten years, two will avoid a prostate cancer death before the age of 85 as a result.
An increased risk of receiving a false-positive PSA test result and have an invasive biopsy that they didn’t require have been identified as the main drawbacks of PSA testing.
PSA Testing and Early Management of Test-detected Prostate Cancer: A guideline for health professionals is recommended for use by all professionals involved in PSA testing and early-stage prostate cancer surveillance, treatment and care and is available for download on the PCFA website.
