New Prostate Cancer Guideline Puts Greater Focus on Early Detection
10 Aug 2026
New Prostate Cancer Guideline Puts Greater Focus on Early Detection
Australia’s updated prostate cancer guideline is placing greater focus on identifying clinically significant cancer early, while supporting active surveillance for men with lower-risk disease.
The new guideline, developed by the Prostate Cancer Foundation of Australia and endorsed by the RACGP and the National Health and Medical Research Council, is the first major update in a decade.
It provides more detail on men who may have at least twice the risk of prostate cancer compared with the overall Australian male population. This includes:
- Men aged over 45 with a significant family history of prostate cancer
- Black men aged over 45 with sub-Saharan African ancestry
- Men aged over 45 with a confirmed BRCA2 gene mutation
Dr Brett Montgomery, a Fremantle GP and RACGP representative involved in developing the guideline, said prostate cancer detection has changed significantly over the past decade.
The guideline continues to recommend the PSA test as the first step when testing is considered. However, a raised PSA result should generally be checked again after one to three months.
If the PSA remains elevated, referral to a urologist is recommended.
The guideline also changes the role of prostate biopsy. Instead of moving directly to a biopsy after a persistently high PSA, an MRI can now help assess whether clinically significant prostate cancer is likely.
This approach may help reduce unnecessary biopsies.
For men diagnosed with low- or very low-risk prostate cancer, active surveillance is now identified as the preferred management approach. This involves regular monitoring rather than immediate treatment.
More than 80% of men in this group are reported to choose monitoring, which can help avoid treatment-related effects such as incontinence and sexual dysfunction.
For men aged 50–69 who choose to undergo testing after discussing the possible benefits and harms, the guideline suggests PSA testing every two years.
The guideline also stresses that this is not a population-wide screening program. Men should have an informed discussion with their GP before deciding whether PSA testing is appropriate.
Men with higher risk factors may consider testing earlier, while PSA testing after age 70 may also be considered in some circumstances. The guideline notes that men aged 70 and over should generally have a life expectancy of at least seven years for PSA testing to be considered.
RACGP President Dr Michael Wright said the updated recommendations provide clearer guidance for GPs on PSA testing, biopsy decisions and the use of prostate MRI.
The Federal Government has also announced $320,000 in funding for the RACGP to develop an education and awareness program to support doctors in discussing prostate cancer testing with patients.
The program will help GPs discuss individual risk, potential benefits and harms, and patient preferences when considering testing.
The RACGP plans to update its Red Book and develop a new decision aid to support evidence-based discussions about prostate cancer testing.
Prostate cancer is Australia's most commonly diagnosed cancer. Cancer Australia estimates that around 29,000 men were diagnosed with prostate cancer in 2025, with about 4,000 deaths recorded that year.
New Prostate Cancer Guideline Puts Greater Focus on Early Detection
Source: RACGP / newsGP; Cancer Australia