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 + FHx or Concerned pt
if median PSA <0.6 –> annual PSA and DRE from 50
if median PSA > 0.6 –> biennial PSA and DRE
- If + FHx or Concerned pt
- PSA + 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