Australia charts global first in prostate cancer diagnosis

Australia is set to become the first country in the world to introduce national clinical guidelines for the early detection of prostate cancer, with the release of the 2025 draft guidelines for public comment.

Following two years of extensive review by leading medical and scientific experts, the new draft guidelines – developed under the stewardship of the Prostate Cancer Foundation of Australia (PCFA) – represent a shift towards a more proactive, evidence-based approach to PSA testing. The six-week public consultation period is now open and will close on Friday, May 25. Final approval by the National Health and Medical Research Council (NHMRC) is expected in August.

Professor Jeff Dunn AO, Chair of the Guidelines Steering Committee and PCFA Chief of Mission and Head of Research, said “We now have the evidence to recommend a new approach to PSA testing – one that is systematic, risk-based, and proactive. If we get this right, we will save lives.

“These guidelines are about giving men the best possible chance of surviving prostate cancer through earlier detection and intervention.”

Adjunct Professor Peter Heathcote, Chair of the Expert Advisory Panel and PCFA National Director, emphasised the guidelines as a landmark for prostate cancer care in Australia.

“These recommendations reflect international best practice and take us one step closer to a nationally organised approach to early detection. This will move us away from an inconsistent, discretionary model to one that gives men and their doctors clear, evidence-based advice,” he stated.

Prostate cancer remains the most commonly diagnosed cancer in Australian men, with more than 26,000 cases each year and nearly 4,000 deaths. The burden of late diagnosis remains high, and survival rates fall dramatically when the disease is detected at a more advanced stage.

The 2025 draft guidelines introduce several key changes aimed at addressing this gap. Among the most significant is a world-first recommendation to offer a baseline PSA test to interested men from the age of 40. General practitioners (GPs) will be strongly encouraged to initiate conversations about PSA testing and offer two-yearly tests to men aged 50–69. The guidelines also overturn previous recommendations against testing men over 70, now advocating testing based on clinical judgment.

Importantly, the draft reinforces that digital rectal examinations are no longer recommended in primary care – a move designed to remove one of the major barriers to testing.

For those at higher risk – men with a family history of prostate cancer or of sub-Saharan African ancestry – the draft guidelines propose testing from age 40 with increased frequency. Aboriginal and Torres Strait Islander men, who face significantly higher mortality rates, are recommended to receive biennial PSA testing starting at age 40.

Anne Savage, PCFA Chief Executive Officer, said the consultation process offers a rare opportunity for collective input into a national strategy.

“We are calling on individuals, experts, and interest groups around the country to provide feedback. Every voice matters – from general practitioners to patients, partners, family members and carers. This is an unprecedented opportunity for Australia to accelerate the early detection of prostate cancer, standing shoulder to shoulder with men and families towards our goal of zero deaths,” Savage stated.

The new guidelines will replace the 2016 Clinical Guidelines for PSA Testing, which are now considered outdated. If backed by public education and adequate investment, the 2025 guidelines could lay the foundation for a national framework capable of dramatically reducing prostate cancer deaths within the next five years.

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