Draft clinical guidelines for the early detection of prostate cancer have been released for feedback by the Prostate Cancer Foundation of Australia (PCFA). 

They will replace the 2016 Clinical Guidelines for prostate-specific antigen (PSA) Testing. 

Key changes include:

• GPs to be pro-active in initiating conversations about PSA testing with all males aged 50–69

• A recommendation to test males aged over 70 subject to their life expectancy

• A recommendation for earlier testing for males at higher risk of prostate cancer mortality such as those with a family history, and those of sub-Saharan ancestry

• A recommendation for testing Aboriginal and Torres Strait Islander males from age 40

• Reinforcement that digital rectal examinations are no longer recommended as initial screening tests

• For males requiring further investigation, recommending a multiparametric MRI (mpMRI) prior to determining if a biopsy is warranted

Many of these recommendations are already commonly clinically practiced.

The guidelines will sit alongside changes to treatment protocols whereby “active surveillance” has largely replaced radical surgery and other intrusive treatments.

The RACGP has announced it will also be updating its patient information sheet, ‘Should I have prostate cancer screening?’ to reflect the new guidance.

Subject to public feedback, the Guidelines will go to the National Health and Medical Research Council for approval later this year.