Download Urologists welcome draft guidelines on prostate cancer testing

MEDIA RELEASE – Thursday 4th December 2014
Urologists welcome draft guidelines on prostate cancer testing
New Australian draft guidelines for prostate cancer testing are an important first step towards ending confusion for
Australian men, and their doctors, about when, and how often they should be tested for prostate cancer and the use of
the Prostate Specific Antigen (PSA) blood test according to the Urological Society of Australia and New Zealand
(USANZ).
Professor Mark Frydenberg, USANZ President Elect said the Australian draft guidelines, formulated by an Expert
Advisory Panel which included general practitioners, public health experts, urologists, pathologists, oncologists,
epidemiologists and allied health professionals, and released today for public consultation, will help to improve the
outcomes derived from prostate cancer testing in the future. Previously there were varying recommendations leading
to uncertainty in some men and their doctors about the appropriate course of action.
“We congratulate the Prostate Cancer Foundation of Australia and Cancer Council Australia for jointly sponsoring and
facilitating the process in the interests of developing a evidence-based consensus position that best serves the interests
of Australian men,” said Professor Frydenberg.
“These draft recommendations will help define which men specifically will benefit the most from testing. Once finalised
they will provide clarity about age brackets and how we deal with different types and stages of prostate cancers in
different circumstances,” said Professor Frydenberg.
The draft guidelines contain recommendations regarding treatment options that should be offered to men diagnosed
with prostate cancer, including the use of Active Surveillance which is already used widely by Australian urologists to
delay definitive treatment in men with lower risk cancer.
Every year about 20 percent of Australian men aged 45 to 74 have a PSA test, with approximately 22,000 of these men
being diagnosed with prostate cancer. Around 120,000 Australian men are currently living with the disease while close
to 3,300 men will die each year in Australia of prostate cancer.
The draft guidelines are available for review at wiki.cancer.org.au/australia/Guidelines:PSATesting.
They include:
For men without a prostate cancer diagnosis or symptoms that might indicate prostate cancer
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For men informed of the benefits and harms of screening who wish to undergo regular testing, offer PSA
testing every two years from age 50 to age 69, and offer further investigation if the PSA is greater than 3.0
ng/mL.
In asymptomatic men interested in undergoing testing for early diagnosis of prostate cancer, digital rectal
examination is not recommended as a routine test in the primary care setting.
Do not offer PSA testing to a man who is unlikely to live another seven years.
Offer evidence-based decisional support to men considering whether or not to have a PSA test, including the
opportunity to discuss the potential benefits and risks of PSA testing before the decision to test is confirmed.
For men undergoing an initial prostate biopsy
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Take 21-24 cores in initial biopsies for the diagnosis of prostate cancer. In addition to the sextant biopsies,
direct 15-18 additional biopsies to the peripheral zones of the prostate.
Active Surveillance and Watchful Waiting
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Offer active surveillance to men with prostate cancer who meet all the following criteria:
PSA ≤ 20 ng/mL, clinical stage T1-2 and Gleason score 6.
Advise men with potentially curable prostate cancer considering watchful waiting that their risk of developing
more advanced prostate cancer and dying from it will be higher with watchful waiting than with immediate
definitive treatment but that, in the medium to long term, watchful waiting is unlikely to diminish their
wellbeing and quality of life.
For further media information or to interview Professor Frydenberg, please contact:
Edwina Gatenby, Maxicom Public Relations +61 2 9460 2711 Mobile: +61 402 130 254 [email protected]
The Urological Society of Australia and New Zealand is the peak professional body for urological surgeons in Australia and New
Zealand. Urologists are surgeons who treat men, women and children with problems involving the kidney, bladder, prostate and
male reproductive organs. These conditions include cancer, stones, infection, incontinence, sexual dysfunction and pelvic floor
problems.