Clinical practice guidelines for PSA testing and early management of test-detected prostate cancer

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Prostate Cancer Foundation of Australia and Cancer Council Australia PSA Testing Guidelines Expert Advisory Panel. Clinical practice guidelines PSA Testing and Early Management of Test-Detected Prostate Cancer. Sydney: Cancer Council Australia. [Version URL:, cited 2024 Feb 26]. Available from:

This resource has been developed, reviewed or revised more than five years ago. It may no longer reflect current evidence or best practice.

Published: 2015

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These guidelines (recommendations) in the web-version of this guideline were approved by the Chief Executive Officer of the National Health and Medical Research Council (NHMRC) on 2 November 2015 under section 14A of the National Health and Medical Research Council Act 1992 In approving the guidelines (recommendations), NHMRC considers that they meet the NHMRC standard for clinical practice guidelines. This approval is valid for a period of five years. NHMRC is satisfied that the guidelines (recommendations) are systematically derived, based on the identification and synthesis of the best available scientific evidence, and developed for health professionals practising in an Australian health care setting.

This publication reflects the views of the authors and not necessarily the views of the Australian Government.

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Note: Please note that the relevant excerpt pages of the technical report are accessible in the appendix of each content page.



About this guideline


Summary of recommendations


1 Risk


2 Testing

2.1. Decision support for men considering PSA testing

2.2. PSA testing strategies

2.3. Role of digital rectal examination

2.4. PSA testing and life expectancy

2.5. Testing with variants of PSA to improve sensitivity after an initial total PSA ≤ 3.0 ng/mL

2.6. Testing with variants of PSA or repeat PSA testing to improve specificity after an initial total PSA > 3.0 ng/mL


3 Prostate biopsy and multiparametric MRI

3.1. Biopsy quality criteria

3.2. Follow-up to a negative prostate biopsy


4 Active surveillance


5 Watchful waiting


6 Sociocultural aspects of PSA Testing in Australia


Appendix 1 Guideline development process

Appendix 2 Committee members and contributors

Appendix 3 List of clinical questions

Appendix 4 TNM classification of prostate tumours

Appendix 5 Abbreviations and glossary

Appendix 6 Conflict of interest register