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Patients age 45 should be able to request PSA test, say new guidelines



Men at higher risk of prostate cancer should be able to have a PSA test when they reach the age of 45, according to new consensus statements.

The recommendations, compiled by Prostate Cancer UK from a survey of over 300 health professionals, say that all men should be able to have a PSA test over the age of 50.

Higher risk men – including black men and those with a family history of prostate cancer – should be able to request the test once they reach the age of 45, even if they are asymptomatic, it says.

The statements adds that GPs should also be prepared to open discussion with these high-risk men about the pros and cons of the PSA test, and that men over 40 who have no symptoms of a prostate problem should think about having a PSA test to help work out their risk of getting prostate cancer later in life.

Current guidelines from Public Health England only recommend PSA testing for men over 50 years, providing they have opened the discussion during an appointment with their GP. PHE advise GPs not to proactively raise the issue with this patient group.

The Prostate Cancer UK recommendations consist of 13 statements in total, and are designed to support ‘primary healthcare professionals to use the PSA test more effectively for men without symptoms of prostate cancer’.

Dr Jon Rees, a GPSI in urology in Somerset and chair of the Primary Care Urology Society, said: ‘These consensus statements offer us some much needed support and guidelines. We consistently fail to make decisions on whether to test or whether to refer for prostate biopsy that are based on an individualised assessment of risk, relying instead on the PSA “normal range” alone.

’But prostate cancer risk factors are the greatest weapon we have. These statements make a strong case for better risk assessment in primary care, and hopefully better targeting of high risk men, while at the same time reducing unnecessary interventions for those at low risk.’

Heather Blake, director of support and influencing at Prostate Cancer UK added: ‘GPs must act to make sure that the PSA test becomes our best means of achieving early detection of prostate cancer in men without symptoms, especially those at higher than average risk.’

The guidance also states that GPs should advise men against having the PSA test if they are asymptomatic and likely to live for less than ten years.

Please note, the original headline said GPs should offer PSA tests to patients aged 45. This was incorrect – the guidelines say patients should be able to request the tests, not that GPs should offer them. The article was changed at 11:30 on 30 March 2016.