Prostate Cancer Screening Recommendations
According to the Cancer Council Australia, men aged 50 to 69 are recommended to have a prostate-specific antigen (PSA) blood test every two years [1]. Men with a family history of prostate cancer or other risk factors are at a higher risk and may need to begin prostate cancer screening earlier, around age 45, to catch signs of prostate cancer [1]. Men with three affected first-degree relatives diagnosed with prostate cancer are considered high risk and are recommended to begin screening every 2 years from the age of 40. [2]. Regular PSA tests and potential follow-up with a DRE help monitor prostate health and check for any abnormalities in the prostate gland [3].
Dr. Gordon O'Neill, a urologist with over 25 years of experience, stresses the simplicity and importance of these exams.
He explains:
“Prostate examinations are really quite simple, and they don’t take very long. They may be transiently uncomfortable, but they provide us with a lot of crucial information. For example, a DRE helps detect non-PSA producing prostate cancers, and also helps us understand the size of the prostate.”
What Does the PSA Test Measure?
A PSA test measures the level of prostate specific antigen in the blood [4], which can indicate prostate cancer or other conditions like benign prostatic hyperplasia (BPH). Traditionally, a PSA level of 4.0 ng/mL or lower is considered normal PSA, but high PSA levels may require further testing, such as a biopsy, to rule out cancer [5].
Elevated PSA levels could also point to benign prostatic hyperplasia (BPH), urinary tract infections (UTIs), or injury to the prostate region [4].
As Dr. O'Neill notes:
“BPH is a condition that affects most men as they age. It involves the gradual enlargement of the prostate in a benign, non-cancerous way. This slow growth can eventually block the bladder outlet, causing urinary symptoms.” He adds, "A PSA test is vital because it’s elevated in all prostate diseases, and helps us screen for prostate cancer before considering any BPH treatment."
For more information, refer to our ultimate Benign Prostatic Hyperplasia (BPH) guide.
What is PSA?
Prostate-specific antigen is a protein that is produced by the prostate gland. A PSA test is a blood test [3] to check whether an individual has high levels of it. Those who have been found to have high levels of PSA may be likely to have issues related to their prostate [4].
Risk Factors and Higher Risk Individuals
According to Cancer Australia [6], prostate cancer was the most commonly diagnosed cancer in the country in 2023. It’s estimated that Australian men have a 1 in 6 (or 17%) risk of being diagnosed with prostate cancer by the age of 85.
Men with a family history of prostate cancer, especially if their father or brother has been diagnosed with prostate cancer, are at a higher risk [7].
According to Dr. O'Neill, a urologist may recommend early PSA screening or more frequent tests for these individuals for early detection of prostate cancer.
In addition to family history, obesity, a Western diet high in fatty foods, and lack of exercise are contributing risk factors for prostate cancer [7].