Table 1.
Guidelines for men at average and high risk.
| Country | Organisation | Year | Recommendations for average risk men | Recommendations for high risk men |
|---|---|---|---|---|
| Australia | Prostate Cancer Foundation of Australia and Cancer Council Australia | 2015 | Biennal screening if PSA<3 ng/mL for ages 50-59 and LE >7 | Test biennially (PSA dependent) if discussion had for ages 40-69
years No further testing until 50 if PSA ≤75th percentile for age |
| Canada | Canadian Task Force on Preventive Health Care | 2014 | Recommends against screening for ages 55–70 | No specific recommendation, encourage discussion Risk factors- Family history, men of black race |
| Canadian Urological Association | 2017 | Offer PSA testing following discussion from ages 50-70 and LE
>10 Test every 4 years if PSA <1 ng/mL Biennial if PSA 1-3 ng/mL More frequent if PSA >3 ng/mL |
Offer PSA testing following discussion Risk factors- Family history, men of black race |
|
| Denmark | Danish Urological (Prostate) Cancer Group (DAPROCA) | 2019 | Recommends against both systematic and opportunistic screening for all ages | PSA testing can be offered to men >45 years and LE
>10-15 Risk factor- Family history |
| Europe | EAU-EANM-ESTRO-ESUR-SIOGa | 2020 | Offer an individualised risk-adapted strategy to well informed
men if >50 years and LE >10-15 Biennial follow-up if PSA >1ng/mL at 40years or >2ng/mL at 60 years |
Offer early testing if >40 years and LE >10-15
years Risk factors- Family history, African descent |
| European Society for Medical Oncology (ESMO) | 2020 | Offer early PSA testing followed by risk adapted strategy if >50 years and LE >10 | Offer early testing if >40 years and LE >10
years Risk factors- Family history, African-American, genetics |
|
| Ireland | National Cancer Control Programme | 2018 | Recommends shared decision making if <50–70 years. PSA level dependent biennial PSA testing | No specific recommendations Risk factors- Family history, African descent |
| Japan | Japanese Urological Association | 2016 | Population-based screening if >50 years Test every 3 years if PSA <1 ng/mL. Annually if PSA meets age-specific cut-offs |
No specific recommendations Risk factors- Family history, genetic mutations |
| New Zealand | Prostate Cancer Working Group & Ministry of Health | 2015 | Test every 2-4 years if discussion has been had to those ages 50-70 | Test annually for men ages 40-70 following
discussion Risk factors- Family history |
| UK | UK National Screening Committee | 2020 | Recommends against systematic population screening for all ages | No specific recommendations Risk factors- Black ethnicity, family history age, genetics, higher BMI |
| Prostate Cancer Risk Management Programme (PCRMP) | 2020 | PSA testing available on request for ages >50 GP should not proactively raise issue |
Use clinical judgement when offering testing to those
<50 Risk factors- Family history, men of black race |
|
| International panel (The BMJ Rapid Recommendations)b | 2018 | Recommends shared decision-making for all ages | No specific recommendations Risk factors- Family history, African descent, low socioeconomic status |
|
| United States | US Preventive Services Task Force (USPSTF) | 2018 | Recommends shared decision making if 55-69 years of
age. Against screening if >70 |
No specific recommendation, but inform men if ages 55-69 years
of age Risk factors- Family history, African-American |
| American Cancer Society | 2020 | Recommends shared decision making. For ages >50 and LE >10 years, test biennially if PSA <2.5 ng/mL, annually if >2.5 ng/mL | Informed decision making if ages >40 and LE >10
years Risk factors- Family history, African-American |
|
| American Urological Association | 2018 | Recommends shared decision making. Biennial screening if 55-69 years | Informed decision making for ages 40-54 Risk factors- Family history, African-American |
|
| American Academy of Family Physicians | 2020 | Recommends shared decision making. Biennial screening for ages 55-69 | No specific recommendations but inform men if ages
55-69 Risk factors- Family history, African-American |
|
| American College of Physicians | 2013 | Recommends shared decision making for ages 50-69 years | Recommends shared decision making for men aged
>40 Risk factors- Family history, African-American |
|
| National Comprehensive Cancer Network (NCCN) | 2019 | Recommends shared decision making. Test every 2-4 years if PSA<1 ng/mL or 1-2 years if PSA 1-3 ng/mL for ages 45-75 years |
Recommends shared decision making and annual PSA testing if
>40 years Risk factors- genetics, African-American |
Note: Comprehensive recommendations and references are available in Appendix 3 (Tables 1 and 2, online supplementary material).
PSA: prostate-specific antigen; LE: life expectancy.
a
European Associaion of Urology – European Association of Nuclear Medicine – European Society for Radiology and Oncology – Uropean Society of Urogenital Radiology– International Society of Geriatric Oncology.
b
A panel of men at risk of prostate cancer, general practitioners, general internists, urologists, epidemiologists, methodologists, and statisticians.