Table 2. Guidelines follow-up recommendations on PSA testing.
| Guideline | Treatment with curative intent | Prostatectomy | External beam radiotherapy | Brachytherapy | Active surveillance | Watchful waiting | Advanced and metastatic disease |
|---|---|---|---|---|---|---|---|
| NICE (2008) | 6 weeks post-treatment, at least every 6 months for the first 2 years, then at least annually | Every 3 months in the first 2 years, then 6 monthly | At least once a year | ||||
| EAU | At 3, 6 and 12 months, then every 6 months until 3 years, then annually | 3 and 6 months after initiating treatment, then every 3–6 months for M1 disease and good treatment response | |||||
| CBO | At 6 weeks, 3, 6, 9 and 12 months, then every 6–12 months for 5–10 years | ||||||
| FCCG | 6–12 months after surgery, then every 6 months for 5 years, then every 12 months | At 3 and 12 months after treatment, then every 6–12 months for up to 5 years, then annually | At 3 months after treatment, then every 6–12 months for up to 5 years, then annually | Every 3–6 months for 5 years, then every 12 months for men on hormone therapy | |||
| SBHW | Every 6 months for 2–5 years | Every 3–6 months | Every 6–12 months | Every 6–12 months for patients without known metastases; every 3–6 months for patients with metastases; at least every 3 months for patients with clinical progression | |||
| NCCN | Every 6–12 months for 5 years, then annually | Every 6 months if life expectancy ⩾10 years, every 6–12 months if <10 years | Every 3–6 months after initial therapy for N1 or M1 disease | ||||
| ACB | 4–8 weeks after surgery, then every 6 months for 2 years, then annually | Every 6 months for 2 years, then annually (intermediate risk) | Every 6 months for 2 years, then annually (intermediate risk) | As a further management option following radical prostatectomy: PSA every 3–4 months | Every 6 months for advanced disease if it will affect management | ||
| Low risk may have PSA only annually | PSA should not be done routinely for metastatic disease, only when it will affect management | ||||||
| ESMO | PSA should be monitored | ||||||
| SOR | Between 1 and 3 months, then every 3 months in the first year (less if < limit of detection) and every 6 months for the next 7 years | Every 6 months for an indefinite period | At regular intervals | ||||
| CCNS | Every 3–12 months in years 1–3 and every 6–12 months from year 3 onwards | Every 3–4 months in years 1–5, then every 3–6 months beyond 5 years | Every 6 months | ||||
| AFU | Within 3 months, then at 6 months, then, every 6 months for 3 years, then annually | Every 6 months for 3 years, then annually | Every 6 months for 10 years is customary practice | Every 3–6 months | Every 6 months for 4 years, then annually | At 3 months to determine nadir following hormone therapy | |
| ACR | Follow-up at 3–6-month intervals for 1–2 years, then periodically, may include PSA | ||||||
| OMHLTC | At 3–12-month intervals | At 3–12-month intervals | Role not yet established | At 3–6-month intervals | At 3–6-month intervals for men undergoing hormone therapy | ||
| NICE (2002) | Regular | ||||||
| BCCA | Every 3 months in the first year, then every 6 months | Every 6 months for 3 years, then annually | Every 3 months for 2 years, then 6 monthly | ||||
| ESTRO | Follow-up every 3 months for the first year, then every 6 months to 5 years, then annually, should include PSA | ||||||
| AUA | Periodic | Periodic, no more than every 3–6 months | Consider regular tests | ||||
| COIN | It is sensible to monitor PSA every 3 months when hormone treatment for metastatic disease is deferred |
Abbreviations: DRE=digital rectal examination; PSA=prostate-specific antigen.