About this guideline
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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
National Health and Medical Research Council 
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.What is in this guideline
This guideline is intended for health professionals working with middle-aged and older men who do not have any symptoms that suggest they might have prostate cancer and are considering having a prostate-specific antigen (PSA) test, or who decide to have a test after they have been informed of the benefits and harms of testing.
It makes recommendations on how best to support men in making an informed decision for or against PSA testing and on which testing protocol to recommend to men who decide in favour of testing, depending on their age and underlying risk of prostate cancer. It also makes recommendations about further investigation after an abnormal PSA test result and the early management of prostate cancer diagnosed following such investigation.
The recommendations in this guideline are intended for people with training in medicine or other health sciences. They are not intended for the general public.
What this guideline does not cover
This guideline does not recommend a population screening program for prostate cancer (a program that offers testing to all men in a certain age group who do not have prostate cancer or symptoms that suggest prostate cancer). Current evidence does not support such a program.
This guideline does not make recommendations about:
- whether, or how, primary care doctors should raise the topic of prostate cancer testing with their male patients
- prostate cancer treatments such as surgical procedures, radiation, chemotherapy or drug treatments
- treatments for adverse effects of prostate cancer treatment, such as urinary and bowel problems and erectile dysfunction
- the management of advanced prostate cancer.
This guideline does not provide:
- detailed guidance on how individual men can make informed decisions about PSA testing or health care that follows it, or how health professionals can facilitate these choices.i Development of a decision aid is underway.
- a full review of factors that may increase risk of prostate cancer sufficiently to justify a PSA testing protocol different from that offered to men at average risk of prostate cancer. Guidance based on such reviews will be included in future editions of this guideline.
- information that would assist men and their doctors to assess men’s expectation of life in the context of deciding whether to initiate or continue PSA testing, or to offer and accept definitive treatment for prostate cancer. Development of a calculator tool based on Australian data is underway.
Footnote
i NHMRC’s document PSA testing for prostate cancer in asymptomatic men: information for health practitioners provides a summary of the evidence on the benefits and harms of testing for use by health practitioners before they discuss the PSA test as part of a medical consultation (NHMRC. Information for health practitioners. Canberra: NHMRC, 2014. Available from: http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/men4d_psa_testing_asymptomatic_men_140304.pdf). A decision tool is being developed to assist doctors to facilitate informed choice for or against testing.