Table 3:

Summary of recommendations for PSA screening for prostate cancer from Canada and elsewhere

OrganizationAge at initiation of PSA screeningScreening intervalAge at discontinuation of PSA screening
Canadian Task Force on Preventive Health Care (current)Routine PSA screening not recommended
Canadian Task Force on the Periodic Health Examination (1994) (11)Routine PSA screening not recommended as part of periodic health examination
US Preventive Services Task Force (2012) (8)PSA screening not recommended; applies to men of all ages
Canadian Urological Association (2011) (54)

  • Average risk: offer at age 50 yr to men with life expectancy ≥ 10 yr

  • Increased risk (e.g., family history of prostate cancer, African descent): offer at 40 yr

  • Offer baseline PSA test at age 40–49 yr to establish future risk of prostate cancer

Not specified75 yr
Canadian Cancer Society (2014) (55)Men aged > 50 yr should talk with their doctor about whether they should be tested for prostate cancerNot specifiedNot specified
American Cancer Society (2012) (56)Average risk: discussion at age 50 yr
Increased risk: discussion at age 40 or 45 yr, depending on extent of risk		PSA < 2.5 ng/mL: 2 yr
PSA ≥ 2.5 ng/mL: annual		Life expectancy < 10 yr
National Cancer Institute (2012) (22)Insufficient evidence to determine whether screening with PSA or digital rectal examination reduces prostate cancer mortality
National Health Service (2013) (57)No organized screening program; informed-choice program = men concerned about the risk of prostate cancer receive clear and balanced information about the advantages and disadvantages of PSA testing and cancer treatment
Prostate Cancer Canada (2013) (58)

  • Offer baseline PSA test at age 40–49 yr

  • Men aged > 40 yr should talk with their doctor about early detection

  • Men at high risk should talk with their primary care provider before age 40 yr about prostate cancer

Not specified≥ 70 yr; decision should be based on individual factors (not specified)
American Urological Association (2013) (59)

  • Routine screening not recommended for men aged 40–54 yr at average risk

  • Shared decision-making recommended for men aged 55–69 yr; decision to proceed based on patient’s values and preferences

≥ 2 yr≥ 70 yr or life expectancy < 10–15 yr
American College of Physicians (2013) (60)Men aged 50–69 yr: clinicians should discuss the limited benefits and substantial harms of screening for prostate cancer; they should not screen for prostate cancer with the PSA test in patients who do not express a clear preference for screeningNot specified≥ 70 yr or life expectancy < 10–15 yr
Cancer Council Australia, Australian Health Ministers’ Advisory Council (2010) (61)PSA test not suitable for population screening

  • Note: PSA = prostate-specific antigen.