Prostate cancer test age lowered to 40

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The age at which men are recommended to first have a test to help identify prostate cancer has been reduced from 50 to 40 years of age.

This recommendation from the Urological Society of Australia and New Zealand (USANZ), which is the peak body for urological surgeons in both countries, is based on evidence that the earlier diagnosis of prostate cancer will reduce the risk of death from the disease.

USANZ says men should first undergo a simple physical examination and blood test at or beyond the age of 40, due to increased awareness of men younger than 50 being diagnosed with prostate cancer, and the publication of medical studies demonstrating a better prognosis if prostate cancer is picked up earlier.

Not all men will require immediate treatment with ?’active surveillance” being appropriate in many cases in the short to medium term. This means the patient is monitored by regular tests and examinations but the cancer is not immediately treated.

Each week more than 10 men under the age of 50 will be diagnosed with prostate cancer in Australia and New Zealand.

USANZ recommends that men aged 40 years or older undergo an initial Prostate Specific Antigen (PSA) blood test following consultation with their GP or urologist which will help to stratify them into risk categories, based on the test results.

“The future risk of prostate cancer is closely related to a man’s PSA level; a baseline PSA level above the median for age 40 is a predictor for prostate cancer. Such testing may not only allow for the earlier detection of more curable cancers, but may also allow for more efficient, less frequent testing”, said USANZ President, Dr David Malouf.

“GPs should be offering a PSA test to 40 year old men in conjunction with a digital rectal examination (DRE) after discussing with them the subsequent potential issues. Those identified as being at higher risk should undergo regular tests; those at low risk should consider less frequent testing.

“A PSA level higher than 0.6 in a 40 year old is considered higher risk, as is a level of higher than 0.7 in a 50 year old, and regular monitoring is recommended for these groups.

“There is now strong evidence that having a baseline PSA test at age 40 is a smart move which can help determine whether a man is in a low risk or high risk category and enabling appropriate follow-up to occur”, Dr Malouf said.

USANZ advises that other factors such as family history of prostate cancer, age, overall health and ethnicity should be combined with the results of PSA testing and physical examination in order to better determine the risk of prostate cancer.

“Prostate cancer testing at any age remains an individual decision that men should make in full consultation with their GP and urologist”, Dr. Malouf said.

Source: Urological Society of Australia and New Zealand, Australia

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