PSA Screening a guide for men and their gps
What is PSA?
Prostate Specific Antigen is a molecule produced by the prostate. Its function is to liquefy semen. PSA levels in the blood are abnormally high in >95% of prostate cancers, especially large aggressive cancers. Those rare cancers with normal PSA are detected by rectal examination (DRE).
Who should be offered a PSA?
Aged between 55 to 75 years and in good health OR
Aged 45 to 55 with a family history of prostate cancer OR
A strong history of breast cancer in the family OR
A suspicious lump on rectal examination
What level of PSA is abnormal?
There is no exact ‘cut-off’ below which no one has cancer or above which all men have cancer
The likelihood of cancer goes up with the PSA level
· For a PSA of 1, the likelihood of cancer is 1 in 1,000
· For a PSA of 2.5, the likelihood of cancer is 1 in 100
· For a PSA of 4, the likelihood of cancer is 1 in 4
· For a PSA of 10, the likelihood of cancer is 1 in 2
· For a PSA of 100, the likelihood is 100%
If PSA is abnormal, what next?
· Do a DRE
· Ensure PSA was not immediately after riding a bike, ejaculation, DRE, catheter insertion or other procedure
· Exclude UTI / prostatitis, give antibiotics if symptoms
· Repeat the PSA after 4 weeks
· Add a Free / total PSA ratio
· Calculate the PSA density and velocity
If Normal, when should spa be repeated?
If PSA < 1 at age 40, repeat at age 50
· For 50 – 75 years, repeat every 2 years
· If borderline, repeat at 4 weeks then at 6 months
Prostate Cancer Risk Calculator Tool (Thompson et al, BJUI , 2017)
Rate for Private billing
Initial Consult: $240.00 with a Medicare Rebate of $76.15
Follow- up Consult: $160.00 with a Medicare Rebate of $38.25
If you have a Health Care or Pension Card the fee may vary, please contact reception on (02) 9331 7546 to discuss.