Appendix 2 Committee members and contributors
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Clinical practice guidelines for PSA testing and early management of test-detected prostate cancer > Appendix 2 Committee members and contributors
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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.
Appendix 2 Committee members and contributors
PCFA and Cancer Council Australia have appointed a designated Project Steering Committee. The Project Steering Committee was responsible for the overall management and strategic leadership of the guideline development process.
Project steering committee
| Name | Position | Project role |
|---|---|---|
| Emeritus Professor Villis Marshall AC | Consultant Urologist; Chair, Australian Commission on Safety and Quality in Health Care, NSW | Chairman of Expert Advisory Panel |
| Professor Sanchia Aranda | Chief Executive Officer, Cancer Council Australia, NSW (from 3 August 2015) | Co-convenor of Expert Advisory Panel (from 3 August 2015) Project governance |
| Professor Bruce Armstrong AM | Emeritus Professor, School of Public Health, The University of Sydney, NSW | Expert advisor in public health Project governance |
| Professor Mark Frydenberg | Head of Urology, Monash Medical Centre, Southern Health, VIC | Expert advisor in urology medicine Project governance |
| Professor Paul Glasziou | Professor of Evidence Based Medicine, Bond University, QLD | Expert advisor in evidence base medicine Project governance |
| A/Professor Anthony Lowe | Chief Executive Officer, Prostate Cancer Foundation of Australia, NSW | Project Convenor Co-convenor of Expert Advisory Panel Project governance |
| Professor Dianne O’Connell | Senior Epidemiologist, Cancer Research Division, Cancer Council NSW | Expert advisor in epidemiology Project governance |
| Professor Ian Olver AM | Chief Executive, Cancer Council Australia, NSW (until 31 December 2014) Director, Sansom Institute, Chair of Translational Cancer Research, University of South Australia (from 23 February 2015) |
Co-convenor of Expert Advisory Panel (until 31 December 2014) Project governance |
| David Sandoe OAM | National Chairman, Prostate Cancer Foundation of Australia, NSW (retired as National Chairman on 31 March 2015) | Consumer representative Project governance |
Project staff
| Name | Position | Project role |
|---|---|---|
| Julie Sykes* | Director of Health and Education Programs, Prostate Cancer Foundation of Australia | Project manager NHMRC point of contact Project governance |
| Dr Tim Wong** | Manager, Advocacy and Resources, Prostate Cancer Foundation of Australia | Project manager Project governance |
| Christine Vuletich*** | Manager Clinical Guidelines Network, Cancer Council Australia | Management of guideline development process Project governance |
| Jutta von Dincklage**** | Head Clinical Guidelines Network, Cancer Council Australia | Management of guideline development process Project governance Technical development and support for the online guideline development |
| Laura Wuellner***** | Project Manager, Clinical Guidelines Network, Cancer Council Australia | Project support |
| Suzy Hughes | Project Coordinator, PSA testing guidelines, Cancer Council Australia | Systematic review team |
| Dr Dana Stefanovic | Project Coordinator, PSA testing guidelines, Cancer Council Australia | Systematic review team |
| Dr Albert Chetcuti | Project Coordinator, PSA testing guidelines, Cancer Council Australia | Systematic review team |
| Tracy Tsang****** | Project Assistant, PSA testing guidelines, Cancer Council Australia | Systematic review team |
| Cindy Peng | Project Assistant, PSA testing guidelines, Cancer Council Australia | Systematic review team |
| Katherine Sheridan | Project Assistant, PSA testing guidelines, Cancer Council Australia | Systematic review team |
| Sam Egger | Bio Statistician, Cancer Council NSW | Performed statistical analysis for meta-analysis on question 7 |
| Jennifer Harman | Medical writer, Meducation | Editorial consultant |
* until 3 July 2014
** until 6 October 2014
*** until 3 July 2014
**** from 4 July 2014, involved as Product Manager, Wiki Development from 2012 to 3 July 2014
***** from 3 September 2014
****** until 14 November 2014
An Expert Advisory Panel comprising of representatives from all specialities involved in the diagnosis and management of men affected by prostate cancer, and consumer representatives, was convened to develop this PSA testing guideline.
The Expert Advisory Panel is working in partnership with the systematic review team on specific clinical questions in keeping with their area of practice. Question Specific Working Parties were convened as required to develop the response to individual questions. The lead author for the individual question co-opted additional experts for this purpose using members of the Expert Advisory Panel as appropriate. The Program Steering Committee sought additional expert consultation during this process, subject to prior approval by the Expert Advisory Panel.
Expert advisory panel
| Name | Position | Specialty |
|---|---|---|
| Emeritus Professor Villis Marshall AC, Chair Expert Advisory Panel | Consultant Urologist; Chair, Australian Commission on Safety and Quality in Health Care, NSW | Urology |
| Professor Sanchia Aranda | Chief Executive Officer, Cancer Council Australia, NSW (from 3 August 2015) | Cancer Control |
| Professor Bruce Armstrong AM | Emeritus Professor, School of Public Health, The University of Sydney, NSW | Epidemiology |
| Dr Joseph Bucci | Radiation Oncologist, Prostate Cancer Institute, St George Hospital, NSW | Prostate Brachytherapy |
| Professor Suzanne Chambers | Professor of Preventative Health, Griffith Health Institute, QLD | Psycho-oncology |
| A/Professor Pauline Chiarelli JP | School of Health Sciences (Physiotherapy), The University of Newcastle, NSW | Rehabilitation |
| Professor Chris Del Mar | Professor of Public Health, Bond University, QLD | General Practice |
| Professor Mark Frydenberg | Chairman, Department of Urology, Monash Medical Centre, Southern Health, VIC | Urology |
| Professor Robert ‘Frank’ Gardiner AM | Centre for Clinical Research, University of Queensland, QLD | Urology |
| Professor Paul Glasziou | Professor of Evidence Based Medicine, Bond University, QLD | General Practice |
| Dr Keen-Hun Tai | Chair, Faculty of Radiation Oncology Genito-Urinary Group, VIC | Radiation Oncology |
| A/Professor Anthony Lowe | Chief Executive Officer, Prostate Cancer Foundation of Australia, NSW | Cancer Control |
| Dr David Malouf | Consultant Urologist, Prostate Cancer Institute, St George Hospital, NSW | Urology |
| A/Professor Paul McKenzie | Senior Staff Specialist Tissue Pathology and Diagnostics, Royal Prince Alfred Hospital, NSW | Pathology |
| Professor Robert McLachlan | Director, Andrology Australia, VIC | Male Reproductive Health |
| Professor Dianne O’Connell | Senior Epidemiologist, Cancer Research Division, Cancer Council NSW | Epidemiology |
| Professor Ian Olver AM | Chief Executive, Cancer Council Australia, NSW (until 31 December 2014) Director, Sansom Institute, Chair of Translational Cancer Research, University of South Australia (from 23 February 2015) |
Cancer Control |
| Dr Ian Roos OAM | Consumer Advocate, Cancer Voices Australia, VIC | Consumer Advocacy |
| Mr David Sandoe OAM | National Chairman Prostate Cancer Foundation of Australia, NSW (retired as National Chairman on 31 March 2015) | Consumer Advocacy |
| A/Professor Ken Sikaris | Director of Chemical Pathology, Melbourne Pathology, VIC | Pathology |
| Professor Martin Stockler | Oncology and Clinical Epidemiology Medicine, Central Clinical School, The University of Sydney, NSW |
Medical Oncology |
| Professor Phillip Stricker AO | Consultant Urologist, St Vincent’s Clinic, NSW | Urology |
| Mr Peter Teiermanis | Consumer, Frankston, VIC | Consumer Advocacy |
| Ms Elizabeth Watt | Head, Clinical School of Nursing at Austin Health, School of Nursing & Midwifery, La Trobe University, VIC | Nursing |
| Professor Simon Willcock | Professor of General Practice, The University of Sydney, NSW | General Practice |
Question Specific Working Party members and contributors
| RISK | ||
| For Australian men, has a family history of prostate cancer been shown to be reliably associated with a 2.0-fold or greater increase in risk of occurrence of or death from prostate cancer when compared to men who do not have a family history of prostate cancer? (PICO question 1) | ||
| Name | Position | Speciality |
| Professor Bruce Armstrong AM* | Emeritus Professor, School of Public Health, The University of Sydney, NSW | Epidemiology |
| Professor Dianne O’Connell | Senior Epidemiologist, Cancer Research Division, Cancer Council NSW | Epidemiology |
| A/Professor David Smith | Research Fellow, Cancer Council NSW | Epidemiology |
| TESTING | ||
| In men without evidence of prostate cancer does a decision support intervention or decision aid compared with usual care improve knowledge, decisional satisfaction, decision-related distress and decisional uncertainty about PSA testing for early detection of prostate cancer? (PICO question 2) | ||
| Name | Position | Speciality |
| Professor Suzanne Chambers* | Professor of Preventative Health, Griffith Health Institute, QLD | Psycho-oncology |
| A/Professor Pauline Chiarelli JP | School of Health Sciences (Physiotherapy), The University of Newcastle, NSW | Rehabilitation |
| Professor Robert ‘Frank’ Gardiner AM | Centre for Clinical Research, University of Queensland, QLD | Urology |
| A/Professor Dragan Ilic | A/Professor, Department of Epidemiology and Preventive Medicine School of Public Health and Preventive Medicine Monash University, VIC | Epidemiology |
| Dr Walid Jammal | General Practitioner, NSW | General Practice |
| Dr David Latini | Assistant Professor of Urology, Baylor College of Medicine, Texas, USA | Urologist |
| Dr Stefano Occhipinti | Senior Lecturer, Griffith Health Institute, Behavioural Basis of Health Program, and School of Applied Psychology Griffith University, QLD | Psychology |
| For men without a prostate cancer diagnosis or symptoms that might indicate prostate cancer what PSA testing strategies (with or without DRE), compared with no PSA testing or other PSA testing strategies, reduce prostate cancer specific mortality or the incidence of metastases at diagnosis and offer the best balance of benefits to harms of testing? (PICO question 3.1) | ||
| Name | Position | Speciality |
| Professor Bruce Armstrong AM* | Emeritus Professor, School of Public Health, The University of Sydney, NSW | Epidemiology |
| Professor Dallas English | Professor & Director, Centre for Molecular, Environmental, Genetic and Analytic (MEGA) Epidemiology, Melbourne School of Population and Global Health, The University of Melbourne | Epidemiology |
| Professor Paul Glasziou | Professor of Evidence Based Medicine, Bond University, QLD | General Practice |
| Dr Michael Caruana | Research Fellow, Lowy Cancer Research Centre, Prince of Wales Clinical School, NSW | Cancer Modelling |
| Dr Yoon-Jung Kang | Research Fellow, Lowy Cancer Research Centre, Prince of Wales Clinical School, NSW | Cancer Modelling |
| For men without a prostate cancer diagnosis or symptoms that might indicate prostate cancer what PSA testing strategies with or without DRE perform best in detecting any prostate cancer or high grade prostate cancer diagnosed in biopsy tissue? (PICO question 3.2) | ||
| Name | Position | Speciality |
| Professor Bruce Armstrong AM* | Emeritus Professor, School of Public Health, The University of Sydney, NSW | Epidemiology |
| Professor Paul Glasziou | Professor of Evidence Based Medicine, Bond University, QLD | General Practice |
| For men without a prostate cancer diagnosis or symptoms that might indicate prostate cancer does a PSA level measured at a particular age in men assist with determining the recommended interval to the next PSA test? (PICO question 3.3) | ||
| Name | Position | Speciality |
| Professor Bruce Armstrong AM* | Emeritus Professor, School of Public Health, The University of Sydney, NSW | Epidemiology |
| Professor Dallas English | Professor & Director, Centre for Molecular, Environmental, Genetic and Analytic (MEGA) Epidemiology, Melbourne School of Population and Global Health, The University of Melbourne | Epidemiology |
| Professor Paul Glasziou | Professor of Evidence Based Medicine, Bond University, QLD | General Practice |
| For men without a prostate cancer diagnosis or symptoms that might indicate prostate cancer what is the incremental value of performing a digital rectal examination (DRE) in addition to PSA testing in detecting any prostate cancer? (PICO question 4) | ||
| Name | Position | Speciality |
| Professor Paul Glasziou* | Professor of Evidence Based Medicine, Bond University, QLD | General Practice |
| Professor Villis Marshall AC | Consultant Urologist | Urology |
| For men without a prostate cancer diagnosis or symptoms that might indicate prostate cancer, how many years after the start of PSA testing is the benefit of PSA testing apparent? (PICO question 5) | ||
| Name | Position | Speciality |
| Professor Robert ‘Frank’ Gardiner AM* | Centre for Clinical Research, University of Queensland, QLD | Urology |
| Dr Jeremy Grummet | Consultant Urologist, Australian Urology Associates, VIC | Urology |
| Professor James Kench | Consultant Pathologist, Royal Prince Alfred Hospital, NSW | Pathology |
| Dr Bruce Kynaston | Consumer advocate, Prostate Cancer Foundation of Australia | Consumer Advocacy |
| A/Professor David Smith | Research Fellow, Cancer Council NSW | Epidemiology |
| Professor Simon Willcock | Professor of General Practice, The University of Sydney, NSW | General Practice |
| A/Professor Scott Williams | Consultant Radiation Oncologist, Peter MacCallum Cancer Centre, VIC | Radiation Oncology |
| Free-to-total PSA % For asymptomatic men with an initial total PSA below or equal to 3.0 ng/mL does measuring free-to-total PSA percentage improve the detection of prostate cancer or high-grade prostate cancer without resulting in unacceptable numbers of unnecessary biopsies, when compared with a single total PSA result above 3.0 ng/mL? (PICO question 6.1 a) For asymptomatic men with an initial total PSA above 3.0 ng/mL, does measuring free-to-total PSA percentage improve relative specificity without compromising prostate cancer or high-grade prostate cancer detection, when compared with a single total PSA result above 3.0 ng/mL? (PICO question 6.1 b) PSA velocity For asymptomatic men with an initial total PSA below or equal to 3.0 ng/mL does measuring PSA velocity improve the detection of prostate cancer or high-grade prostate cancer without resulting in unacceptable numbers of unnecessary biopsies, when compared with a single elevated total PSA result above 3.0 ng/mL? (PICO question 6.2 a) For asymptomatic men with an initial total PSA above 3.0 ng/mL, does measuring PSA velocity improve relative specificity without compromising prostate cancer or high-grade prostate cancer detection, when compared with a single total PSA result above 3.0 ng/mL? (PICO question 6.2 b) Prostate Health Index (PHI) For asymptomatic men with an initial total PSA below or equal to 3.0 ng/mL does measuring the Prostate Health Index (PHI) improve the detection of prostate cancer or high-grade prostate cancer without resulting in unacceptable numbers of unnecessary biopsies, when compared with a single elevated total PSA result above 3.0 ng/mL? (PICO question 6.3 a) For asymptomatic men with an initial total PSA above 3.0 ng/mL, does measuring the Prostate Health Index (PHI) improve relative specificity without compromising prostate cancer or high-grade prostate cancer detection, when compared with a single elevated total PSA result above 3.0 ng/mL? (PICO question 6.3 b) Repeated total PSA For asymptomatic men with initial total PSA above 3.0 ng/mL, does repeating the total PSA test and using an initial and repeat total PSA above 3.0 ng/mL as the indication for biopsy, improve relative specificity without compromising prostate cancer or high-grade prostate cancer detection, when compared with a single total PSA result above 3.0 ng/mL as the indication for biopsy? (PICO question 6.4) | ||
| Name | Position | Speciality |
| A/Professor Ken Sikaris* | Director of Chemical Pathology, Melbourne Pathology, VIC | Pathology |
| Professor Villis Marshall AC* | Consultant Urologist | Urology |
| Dr David Malouf | Consultant Urologist, Prostate Cancer Institute, St Georges Hospital, NSW | Urology |
| PROSTATE BIOPSY AND MULTIPARAMETRIC MRI | ||
| For men undergoing an initial prostate biopsy how many biopsy cores, which pattern of biopsy sampling sites and which approach constitute an adequate prostate biopsy? (PICO question 7) | ||
| Name | Position | Speciality |
| Professor Villis Marshall AC* | Consultant Urologist | Urology |
| A/Professor Paul McKenzie* | Senior Staff Specialist Tissue Pathology and Diagnostics, Royal Prince Alfred Hospital, NSW | Pathology |
| Professor Bruce Armstrong AM | Emeritus Professor, School of Public Health, The University of Sydney, NSW | Epidemiology |
| In men who have been referred with suspected prostate cancer, what are the prognostic factors that determine the need for further investigation following a prior negative biopsy? (PICO question 8.1) In men with suspected prostate cancer whose initial TRUS biopsy is negative, what should be the next investigation(s)? (PICO question 8.2) | ||
| Name | Position | Speciality |
| Professor Robert ‘Frank’ Gardiner AM* | Centre for Clinical Research, University of Queensland, QLD | Urology |
| Professor Suzanne Chambers | Professor of Preventative Health, Griffith Health Institute, QLD | Psycho-oncology |
| Professor Paul Glasziou | Professor of Evidence Based Medicine, Bond University, QLD | General Practice |
| A/Professor Nathan Lawrentschuk | Consultant Urologist, University of Melbourne; Department of Surgery, Austin Hospital, VIC | Urology |
| Professor Phillip Stricker AO | Consultant Urologist, University of Melbourne; Department of Surgery, Austin Hospital, VIC | Urology |
| Dr Keen-Hun Tai | Chair, Faculty of Radiation Oncology Genito-Urinary Group, VIC | Radiation Oncology |
| Professor James Kench | Consultant Pathologist, Royal Prince Alfred Hospital, NSW | Pathology |
| ACTIVE SURVEILLANCE | ||
| For men with biopsy-diagnosed prostate cancer, for which patients (based on diagnostic, clinical and other criteria) does active surveillance achieve equivalent or better outcomes in terms of length and quality of life than definitive treatment? (PICO question 9) | ||
| Name | Position | Speciality |
| Professor Mark Frydenberg* | Chairman, Department of Urology, Monash Medical Centre, Southern Health, VIC | Urology |
| Professor Phillip Stricker AO* | Consultant Urologist, St Vincent’s Clinic, NSW | Urology |
| For men with biopsy-diagnosed prostate cancer following an active surveillance protocol, which combination of monitoring tests, testing frequency and clinical or other criteria for intervention achieve the best outcomes in terms of length and quality of life? (PICO question 10) | ||
| Name | Position | Speciality |
| Professor Mark Frydenberg* | Chairman, Department of Urology, Monash Medical Centre, Southern Health, VIC | Urology |
| Professor Phillip Stricker AO* | Consultant Urologist, St Vincent’s Clinic, NSW | Urology |
| WATCHFUL WAITING | ||
| For men with biopsy-diagnosed prostate cancer, for which patients (based on diagnostic, clinical and other criteria) does watchful waiting achieve equivalent or better outcomes in terms of length and quality of life than definitive treatment? (PICO question 11) | ||
| Name | Position | Speciality |
| Professor Robert ‘Frank’ Gardiner AM* | Centre for Clinical Research, University of Queensland, QLD | Urology |
| Dr Jeremy Grummet | Consultant Urologist, Australian Urology Associates, VIC | Urology |
| Professor James Kench | Consultant Pathologist, Royal Prince Alfred Hospital, NSW | Pathology |
| Dr Bruce Kynaston | Consumer advocate, Prostate Cancer Foundation of Australia | Consumer Advocacy |
| A/Professor David Smith | Research Fellow, Cancer Council NSW | Epidemiology |
| Professor Simon Willcock | Professor of General Practice, The University of Sydney, NSW | General Practice |
| A/Professor Scott Williams | Consultant Radiation Oncologist, Peter MacCallum Cancer Centre, VIC | Radiation Oncology |
| For men with prostate cancer following a watchful waiting protocol, which combination of monitoring tests, testing frequency and clinical or other criteria for intervention achieve the best outcomes in terms of length and quality of life? (PICO question 12) | ||
| Name | Position | Speciality |
| Professor Phillip Stricker AO* | Consultant Urologist, St Vincent’s Clinic, NSW | Urology |
| Professor Martin Stockler* | Oncology and Clinical Epidemiology Medicine, Central Clinical School, University of Sydney (NSW) | Medical Oncology |
*Lead author
Acknowledgements
- This guideline is dedicated to the memory of Dr Ian Roos OAM, who passed away on 10 April 2015 after a long battle with prostate cancer. Ian was a scholar, scientist, administrator, educator, guide, philosopher and friend of Cancer Council Australia and Prostate Cancer Foundation of Australia. His work as a consumer representative, patient advocate and policy advisor, since his diagnosis with an aggressive prostate cancer 16 years ago, set him apart. Dr Roos will be greatly missed.
- Cancer Council NSW for its in kind support for performing the statistical analysis of question 7 by Sam Egger.
- Petra Macaskill, Professor of Biostatistics, Screening and Test Evaluation Program at the University of Sydney, for her input regarding the analysis of PSA testing diagnostic performance data.
- Annette Pflugfelder MD, PhD Student, Dermatology Research Centre at The University of Queensland and Kelvin Hill, National Manager Clinical Programs, for assessing the draft guidelines with the AGREE II instrument.
- Yaping Liu, Librarian at Cancer Council NSW for helping to collect references.
- Charley Wang, intern at Cancer Council Australia for helping to collect full text of articles.