Australia Just Overhauled Prostate Cancer Testing – Here’s What the New Guidelines Mean for You

Australia has adopted landmark new guidelines for detecting prostate cancer, replacing recommendations that had stood for almost a decade. For men in the Starts at 60 age bracket specifically, these changes are worth understanding properly, because they directly affect when and how often you should be discussing testing with your GP.

What’s actually changing

The new guidelines, developed by the Prostate Cancer Foundation of Australia (PCFA) and approved by the National Health and Medical Research Council on 18 May 2026, replace the previous 2016 PSA testing guidelines. The biggest changes include:

GPs should now proactively raise PSA testing with men from age 50, and from age 45 for men at higher risk (including those with a family history of prostate cancer or of sub-Saharan African ancestry).
A multiparametric MRI is now recommended before biopsy, a change expected to meaningfully reduce the number of unnecessary biopsy procedures men are put through.
Men aged 70 and over may continue PSA testing following an individual clinical assessment, replacing the previous blanket age cut-off that discouraged testing in this group altogether.

New national PSA testing pathways based on a man’s age and individual risk factors, with clearer thresholds for when a result should trigger further investigation.
Professor Jeff Dunn AO, Chair of the Guideline Steering Committee, said the changes reflect two years of rigorous review by leading medical and scientific experts, developed in partnership with the Royal Australian College of GPs. Earlier drafts of the guidelines described the changes as designed to make testing “systematic, risk-based, and proactive,” with the explicit goal of reducing prostate cancer deaths.

Why the age-70 change matters so much

Of everything in this update, the change for men over 70 is likely to have the biggest real-world impact for many Starts at 60 readers. The old guidelines effectively discouraged PSA testing past a certain age, based on the reasoning that many prostate cancers in older men grow slowly enough that they’re unlikely to cause harm within a man’s remaining life expectancy. The new approach replaces that blanket cut-off with individual clinical judgement – recognising that a healthy, active man in his early 70s may have a very different risk-benefit picture to a man the same age managing several other serious health conditions.

Just how common is prostate cancer in Australia?

The numbers explain why this update matters so much. Almost 29,000 Australian men are expected to be diagnosed with prostate cancer this year, and almost 4,000 will die from it – making it the most commonly diagnosed cancer in the country. More than 80 per cent of men diagnosed are aged over 60, with the highest rate of diagnosis occurring in men aged 70 to 74.

There is genuine good news buried in these numbers, too: five-year relative survival for prostate cancer has climbed from 60 per cent in the late 1980s and early 1990s to 96 per cent today, one of the most dramatic survival improvements of any cancer type in Australia, reflecting both earlier detection and better treatment.

The new way of treating it, too

The detection changes come alongside genuine advances in how prostate cancer is being treated. Sydney urologist Associate Professor Celi Varol has spent close to a decade developing an MRI-guided laser ablation technique, commercialised as ProFocal, that destroys cancerous tissue within the prostate while leaving the healthy gland intact – a significant departure from traditional surgery or full-gland radiation, both of which carry a real risk of incontinence and erectile dysfunction.

Early results from trials at Nepean Hospital have been striking: the procedure is done as a day-only intervention, with patients typically going home the same day and reporting minimal to no side effects. Associate Professor Varol has described patients returning to normal activities, including golf, the very next day.

“With the assistance of MRI we’re able to target the cancer with the highest of accuracy. By targeting the cancer itself, and leaving the organ intact we are providing an opportunity for our patients to experience next to no side effects,” Associate Professor Varol said.

For men with more advanced, treatment-resistant prostate cancer, a world-first Australian trial called EVOLUTION has also shown promise, finding that combining a nuclear medicine treatment called LuPSMA with immunotherapy nearly doubled the proportion of patients who remained progression-free after a year, compared to the nuclear medicine treatment alone.

What this means for you

If you’re a man aged 50 or over – or younger with a family history of the disease – it’s worth raising these new guidelines directly with your GP at your next appointment, rather than waiting to be asked. If you’re over 70 and were previously told PSA testing wasn’t recommended for you, that advice may no longer apply under the new individual assessment approach, and it’s worth revisiting the conversation. And if you or someone close to you has been diagnosed and has been anxious about the side effects historically associated with treatment, it’s genuinely worth asking your urologist what’s now available, given how much progress has been made even in the past few years.

This article reports on newly approved clinical guidelines and published research, and is general in nature. It isn’t personalised medical advice — talk to your GP about what these changes mean for you specifically.