Every day in Australia, 79 men are diagnosed with prostate cancer, and 11 men die from the disease. Early detection and treatment remain critical to reducing deaths and improving survival outcomes. That's why clear, evidence-based guidance on prostate cancer testing matters.
In 2025, Australia became the first country in the world to introduce nationally coordinated, evidence-based clinical guidelines for the early detection of prostate cancer, led by PCFA.
These world-first draft guidelines set out the recommended approach for PSA testing and early investigation and form the basis of PCFA's advice to Australian men and their doctors.
The recommended first step: the PSA test
Testing for prostate cancer is done using a simple blood test called the PSA test (or prostate specific antigen test). Depending on your symptoms, risk factors, medical and family history, this will often be the first test you'll have to check for any issues with your prostate.
PSA is a protein made in the prostate, a walnut-sized gland located below the bladder and in front of the rectum. Some PSA naturally enters the bloodstream, which can then be measured through a PSA test.
It is normal for the prostate to grow larger and produce more PSA from around the age of 40. That is why PSA levels are interpreted according to age. If your PSA levels are higher than they should be for your age, it means that there is something going on with your prostate that needs further investigation.
Updated 2025 Australian draft guidelines for prostate cancer testing recommend that men interested in their health consider a baseline PSA test at age 40.
Medicare covers the cost of one PSA test a year for men who are at a high risk of prostate cancer and one PSA test every two years for men at an average risk of the disease.
If your PSA test result shows elevated PSA levels for your age, you may be offered more tests and examinations, including:
- Repeat PSA tests
- Magnetic resonance imaging (MRI) scan
- Digital rectal examination
- Prostate tissue biopsy
Why PCFA supports PSA testing
Australia's new early detection guidelines were developed through a rigorous review of international evidence and led by PCFA in partnership with leading clinicians and researchers. They are designed to reduce avoidable deaths, improve early detection, and ensure equitable access to evidence-based care.
PSA testing is supported by national clinical guidelines, is widely available across Australia, is Medicare-funded, and is backed by decades of research and real-world data. Early PSA testing remains the cornerstone of prostate cancer detection in Australia. The referral to a specialist and the addition of an MRI, which is more readily available in Australia than in other countries, allow biopsies to be more targeted, reduce the risk of unnecessary biopsies, and enable further assessment and management of any other urological signs and symptoms the patient may be experiencing.
What about other tests available overseas?
Several newer prostate cancer tests are available or under development overseas. While some show promise, many remain unsupported by limited data, have been studied in small or specific populations, or are not approved for use in Australia.
PCFA does not currently recommend these tests as a substitute for PSA testing.
EpiSwitch
EpiSwitch is a blood test marketed by Oxford Biodynamics and currently available in the United Kingdom and the United States. The test combines PSA levels with five epigenetic biomarkers and provides a result indicating either a low or high likelihood of prostate cancer.
EpiSwitch is not available in Australia, and no application for Therapeutic Goods Administration (TGA) approval has been lodged. TGA authorisation is required for any therapeutic goods to be lawfully supplied in Australia - a regulatory safeguard that rigorously applies scientific and clinical expertise to evaluate safety, quality and effectiveness before approval. The test has so far been trialled in a very small study involving 147 men who already had a confirmed diagnosis of prostate cancer.
While the study reported that the test was able to predict prostate cancer 92% of the time and correctly identify those without prostate cancer 94% of the time, further research is required to determine how well it performs in broader groups of men who do not already have a known diagnosis
Repeat trials across men of different ages, ethnicities, and family histories would be needed to confirm that the test performs consistently and accurately in real-world screening settings. The authors of the original study recommend a larger scale, blinded trial in a general population cohort as an immediate next step- this has yet to be commenced. The test currently costs between £800 and £900 (approximately AUD $1,500 to $1,800), which may limit accessibility. At this stage, more robust evidence is required before this approach could be considered for routine use in Australia.
MyProstateScore (MPS-2)
MyProstateScore, or MPS-2, is a urine-based test available in the United States. It screens for 18 genetic markers associated with clinically significant prostate cancer.
As of January 2025, no application has been made to register this test with the TGA, and the company has not indicated plans to introduce it to Australia. The initial clinical trial included 761 men, although only four per cent of participants were African American, highlighting the need for further evaluation across more diverse populations. The study was also limited by the fact that a targeted biopsy was not undertaken.
While MPS-2 may contribute to ongoing research into prostate cancer detection, it is not currently part of Australian clinical practice and is not recommended under PCFA-led guidelines.
'Spit Test' At Home Saliva Test
A saliva-based genetic test is also under investigation in the United Kingdom through the TRANSFORM clinical trial. This test uses polygenic risk scores derived from 130 genetic variations linked to prostate cancer risk.
At present, the saliva test is not commercially available and remains in the research phase. Early findings suggest it may help identify men at higher genetic risk, but further large-scale validation is required before it could be incorporated into routine screening programs.
The bottom line
In Australia, the PSA blood test remains the established and recommended first step in early prostate cancer detection. It is accessible, Medicare-supported and underpinned by nationally coordinated clinical guidance led by PCFA.
While emerging technologies overseas may play a role in the future, they are not currently approved, validated at a population level, or recommended within Australia's evidence-based guidelines.
Men concerned about their prostate health should speak with their GP and follow the nationally recommended approach to early detection.
