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PSA - Prostate specific antigen
SCREENING
There is no agreed worldwide standard on when to begin screening PSA or whether to screen PSA at all for prostate cancer detection.
The USANZ (Urological Society of Australia & NZ)
PSA TESTING POLICY SUMMARISED
- 50-70 y.o men
- PSA + DRE annually offered
- 40-50 y.o men
- PSA + DRE spot test
--> If + FHx (father, brother, mother breast cancer)
--> or Concerned pt
--> or if PSA > 0.6 (median)
Then begin annual testing from that date onwards.
--> If PSA < 0.6 then,
Annual test from 50yo
TESTS:
• PSA age specific
• PSA Kinetics (annual rise)
• DRE
• Free/total PSA
• PSA density, PSA – chi
REFER:
• PSA > upper limit age specific
• PSA > 0.375ng/ml/year (if PSA 0-4)
• PSA > 0.75ng/ml/year (if PSA 4-10)
• DRE abnormal
• Young pt (< 50)
+ FHX
+ median PSA > 0.6