Public Consultation on the draft 2025 Clinical Practice Guidelines for the Early Detection of Prostate Cancer

GPSA is seeking your input...

As you no doubt know, prostate cancer is the most commonly diagnosed cancer in Australia, accounting for 16% of all cancers diagnosed and for 1 in 3 of all cancers diagnosed among Australian men.

The draft 2025 Clinical Practice Guidelines for the Early Detection of Prostate Cancer (‘the Guidelines’) will be released for public comment on Monday April 14, following two years of exhaustive work led by Prostate Cancer Foundation Australia (PCFA) in close collaboration with experts and consumers from around the country. 

The new Guidelines will supersede the 2016 Clinical Practice Guidelines for PSA Testing, recognising that significant advancements in diagnosis and treatment have  created an evidence-based pathway for a more structured testing program, mitigating the risks of overdiagnosis.

Australia will become the first country in the world to publish formal clinical guidelines on the early detection of prostate cancer, significantly strengthening our work towards zero deaths in our lifetime. 

Public Consultation Period: 14 April - 25 May 2025

An integral part of the Guideline review is public consultation to provide stakeholders, including consumers, clinicians and other end-users an opportunity to review the content, quality, legitimacy and acceptability of the updated Guidelines. Therefore, a public consultation period for the 2025 Guidelines for the Early Detection of Prostate Cancer in Australia will open on the 14th of April and close on the 25th of May 2025.

This review process has been endorsed by National Health and Medical Research Council and is supported by the Commonwealth Government, with discussions currently underway in relation to implementation.

Background

The objective of this review was to update the existing 2016 Clinical practice guidelines for Prostate Specific Antigen (PSA) Testing and Early Management of Test-detected Prostate Cancer which expired in 2021.

The 2016 Guidelines provide evidence review, advice and clinical practice recommendations including PSA testing strategies for asymptomatic men who have made an informed choice to be tested, imaging and biopsy, active surveillance, watchful waiting and sociocultural aspects of PSA testing. 

Clinical practice points include evidence- and consensus-based recommendations, with the strength of evidence for each graded according to the NHMRC GRADE assessment protocol.

Since 2016, new evidence, standards of care, and technologies have improved the way prostate cancer is diagnosed, treated, and managed. An update to the Guidelines is required to ensure alignment with the latest evidence and best practice care.

The project is being delivered by Prostate Cancer Foundation of Australia under an Agreement with the Commonwealth Department of Health.

The revised Guidelines will outline recommendations that include but are not limited to:

• Advice for consumers and health professionals about how best to support men in making an informed decision for or against PSA testing, taking into consideration potential benefits and possible harms
• Advice about testing strategies to recommend to men who decide in favour of testing, depending on their age, family history and other concerns and potential risk factors for prostate cancer
• Recommendations about further investigation after a PSA test result
• The early treatment/management/surveillance of prostate cancer diagnosed following such investigation, ensuring alignment with the Optimal Care Pathway for prostate cancer

The Need for Review

Prostate cancer is a major cause of mortality and morbidity in Australia. It is the second leading cause of cancer death in Australian men after lung cancer.

In the seven years since the current clinical practice guidelines for PSA testing and management of test-detected prostate cancer were published, an estimated 23,670 Australian men have died from prostate cancer.

Projections published in The Lancet Public Health in 2022 (led by the Daffodil Centre) estimate that 600,329 Australian men will be diagnosed with prostate cancer and 116,385 men will die from prostate cancer between 2020 and 2044.

The evidence to date, as documented in the current (2016) NHMRC-approved guidelines generally recommends that men make informed decisions about PSA testing to indicate prostate cancer risk. Emerging evidence from international and Australian modelling indicates that more structured recommendations may have a greater public health benefit. The 2016 guidelines are in urgent need of an update. 

A copy of the 2016 Guidelines is available via the following link:
https://www.pcfa.org.au/awareness/for-healthcare-professionals/clinical-practice-guidelines-on-psa-testing/

As the supervisors of tomorrow's GP and RG workforce, we welcome your contribution to GPSA's submission for this review process. Please email [email protected] with your suggestions adn observations.