A group of leading health professionals have agreed radical new guidance for administering the PSA test – including baseline testing for concerned men in their 40s and offering the test to men from 45 in high risk groups – which builds on the latest PSA advice released by Public Health England today.

29 Mar 2016
In - Policy PSA

We have set an ambitious aim to reduce deaths from prostate cancer by half over the next decade, and we need to dramatically improve diagnosis if this is to be achieved. We want to develop a definitive test which can enable effective risk-based screening within a few years.

But until then, we want to make sure that the PSA test becomes our best means of achieving early detection of prostate cancer in men without symptoms, especially those at higher than average risk.

Current recommended age for PSA too late for high risk men

Under current Public Health England (PHE) rules, any man in the UK aged 50 and over who asks for a PSA test and carefully considers the implications with their GP has the right to one. But for those men at higher than average risk of the disease, this could be too late. We want these men to have the potential for prostate cancer to be detected early, before they develop symptoms and the disease is advanced and likely to be more difficult to treat.

In a concerted effort to go beyond the PHE guidance, we convened a powerful group of doctors, nurses, consultants and professional bodies (BAUS, BAUN, PCUK and RCGP) to agree recommendations for using the PSA test more effectively. Our aim is to save more lives by helping GPs detect cancer before men get the symptoms that mean the disease is advanced.

Our radical new recommendations go further than PHE advice

Today, we have released the 13 ‘consensus statements’, which build on the advice from PHE but can go much further in advising GPs as they are based on clinical consensus, rather than published evidence from lengthy clinical trials. The radical shift from existing practice includes recommendations that:

  • Health care professionals should discuss the PSA test with men without symptoms from the age of 45 who are at higher than average risk of the disease. This includes Black men or men with a family history of prostate cancer.
  • GPs should explore using the PSA test to provide a ‘baseline’ for men in their 40s who are concerned about prostate cancer, in order to work out their risk of getting prostate cancer later in life.
  • If a man has no symptoms of a prostate problem and is clearly likely to live for less than 10 more years, his GP or practice nurse should advise him not to have a PSA test.

"It’s been confusing for men," said Angela Culhane, Prostate Cancer UK’s chief executive. "The PSA test is controversial and notoriously imprecise, but it’s the best thing we’ve got, and it must be made to work better on the frontline.

This expert guidance plugs gaps in the official rules and brings detail and clarity. It puts advice agreed by hundreds of specialists at the GP’s fingertips

"A man dies every hour from prostate cancer and this expert guidance plugs gaps in the official rules and brings detail and clarity. It puts advice agreed by hundreds of specialists at the GP’s fingertips. Men can now ask for a really informed discussion with their doctor - and consider getting tested younger.

"Men need clarity over when and why they should be tested, and we’re proud to have faciltated this guidance to help frontline clinicians reduce the number of men who are diagnosed too late. We have a target to halve deaths from prostate cancer within the decade, and that can’t be achieved without improving diagnosis."

We will be sharing the consensus statements with primary health care professionals and encouraging them to use them as an additional support alongside the guidance from Public Health England, to help men make the best decisions for their own individual situation.

For a full list of the consensus statements please visit our PSA consensus page.

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