Early detection and screening

Prostate cancer is typically slow growing. High PSA levels can occur five to ten years before the onset of prostate cancer symptoms and early prostate cancer often has no symptoms. The PSA test can help to detect cancer at this early stage.

At present, however, health authorities do not recommend widespread ‘screening’ for prostate cancer. While we have some evidence that regular testing may prevent prostate cancer deaths, there are concerns that many men may be diagnosed and treated unnecessarily as a result of being screened, with a high cost to their health and quality of life.

Discuss testing with your doctor

Most authorities suggest that a man makes his own choice about whether or not to be screened for prostate cancer. This should be done in discussion with your doctor, after considering the benefits and uncertainties of testing and your own risk from the disease.

The Urological Society of Australia and New Zealand has suggested that a single test at the age of 40 years or more may be the best way of assessing a man’s risk of prostate cancer over the following 15–20 years. Men with a father or brother who were diagnosed with prostate cancer at an early age are also at higher risk.

In Australia, Medicare covers an annual check, but this may not be necessary for all men who choose to be screened. The frequency with which you should be checked will be influenced by your first test result. If a man chooses to be tested for prostate cancer, both a PSA test and DRE are recommended to give the best chance of detecting the cancer.