For years, prostate cancer screening has been one of those slightly confusing areas of men’s health.

Should I have a blood test? When should I start? What if it’s high? Does that mean cancer? Will I need a biopsy? And… what about that examination?

The good news is that Australia now has updated prostate cancer guidelines, and as a GP, I’m very pleased to see some clear, practical guidance.

The aim is simple: find the prostate cancers that matter, while avoiding unnecessary tests and treatment. And with prostate cancer being the most commonly diagnosed cancer in Australia, affecting around 29,000 Australian men in 2025, this is important stuff.

First, some good news about that examination…

If prostate screening has you picturing a rubber glove and an awkward few minutes with your GP, good news, blokes!

For men without symptoms, the infamous “finger test” — the digital rectal examination — is no longer recommended as a routine screening test for prostate cancer in general practice.

These days, we start with a conversation and a simple blood test.

So, great news, blokes — that’s ONE more reason to pop in and see your GP. A quick chat, a simple blood test, and no rubber glove required!

So, when should you start?

For most blokes, 50 is the age to start the conversation.

The test is called a PSA — Prostate Specific Antigen — and if you decide to be screened, it’s generally recommended every two years between 50 and 69.

A quick anatomy refresher: the prostate is a little gland roughly the size of a walnut. It produces PSA, which we can measure in your blood. A higher PSA can be a warning sign, but importantly, a raised PSA does NOT automatically mean prostate cancer.

But 50 isn’t a magic number

Some blokes should start the conversation earlier.

If your brother has had prostate cancer, your father was diagnosed before 65, or prostate cancer has affected several men in your wider family, don’t wait until you’re 50.

Have a chat with your GP from your mid-40s about whether PSA testing is right for you.

Which brings me to my public-service announcement:

If you know a bloke in his 40s or older, give him a nudge to check in with his GP about prostate health.

Your husband. Partner. Dad. Brother. Mate. Work colleague.

A simple, “Hey, have you ever asked your GP about a prostate blood test?” could be a surprisingly useful conversation.

And what if you’re an older bloke?

Turning 70 doesn’t automatically mean you’ve aged out of prostate screening either.

The new guidance takes a much more individual approach. If you’re likely to have at least another seven years ahead of you, PSA testing can still be considered.

So if you’re 72, fit, healthy, walking the dog, travelling, playing golf, chasing the grandkids — or still working because apparently retirement looked too relaxing — have the conversation with your GP.

We’re interested in how much life you’ve got ahead of you, not just the number of candles on your birthday cake.

The MRI has been a game changer

This is another part of the new approach that I really like.

A raised PSA used to potentially send a bloke fairly quickly down the road towards a prostate biopsy.

Now we have MRI of the prostate, which allows us to take a much closer look and helps work out whether a biopsy is actually needed.

That’s a big step forward: better information, more targeted investigation and fewer unnecessary procedures.

And finding cancer doesn’t always mean rushing into treatment

We’re also much better at recognising that prostate cancers aren’t all the same.

Some are aggressive and need treatment. Others are slow-growing and may be safely monitored using what’s called active surveillance.

I think of the modern approach like this:

Find the important cancers. Investigate smarter. Treat the cancers that need treating. And leave well enough alone when it’s safe to do so.

What do I do as a GP?

I use these principles in general practice every day.

Prostate screening isn’t about ticking a box on a pathology form. I look at the bloke sitting in front of me — his age, family history, symptoms, previous PSA results, general health and what matters to him.

That’s prevention at its best.

So, to blokes everywhere — don’t wait until something feels wrong.

If you’re in your 40s or beyond, next time you see your GP, simply ask:

“Do I need to think about prostate cancer screening?”

It could be the main life saving question you ask all year.

Find out more about LifeVest’s GP-led approach to preventive health at https://lifevest.com.au/.

Disclaimer: The information shared by LifeVest Pty Ltd is for general education and information only and is not medical advice. Please speak with your GP, specialist, or healthcare professional for advice about your own health and circumstances.