Screening

There is no agreed worldwide standard on when to begin screening or whether to screen at all.

PSA TESTING POLICIES SUMMARISED

  • 50-75 y.o men
    • PSA + DRE annually offered
  • 40-50 y.o men
    • PSA + DRE
      • If + FH or Concerned pt
        if median PSA <0.6  –> annual PSA and DRE from 50
        if median PSA > 0.6 –> biennial PSA and DRE

Tests

  • PSA age specific
  • PSA Kinetics (annual rise)
  • DRE
  • PSA median (if 40-50yo)
  • Free/total PSA
  • PSA density, PSA – chi

Refer

  • PSA > upper limit age specific
  • Rising PSA
    • > 0.35ng/ml/year (if PSA 0-4)
    • > 0.75ng/ml/year (if PSA 4-10)
  • DRE abnormal
  • Young pt (< 50)
    • + FHX (first degree relative diagnosed at < 55yo)
    • + median PSA > 0.6