PSA

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_x  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)
  • + FH_{X (first degree relative diagnosed at < 55yo)}
  • + median PSA > 0.6