Prostate cancer is the most commonly diagnosed cancer in Australian men. Testing for it has always been a conversation rather than a checkbox, because the aim is to find the cancers that matter without putting men through treatment for the ones that never would have.
What a PSA test actually is
PSA stands for prostate specific antigen — a protein made by the prostate that circulates in the blood in small amounts. The test is an ordinary blood test, taken from the arm. At Gosford Doctors it is collected on site through 4Cyte Pathology, usually straight after your appointment.
A raised PSA does not mean cancer. PSA rises with age, with an enlarged prostate, with infection or inflammation, after vigorous cycling and after ejaculation. That is exactly why the result is read in context rather than against a single number, and why one slightly raised reading usually leads to a repeat test rather than anything dramatic.
A digital rectal examination is no longer routinely recommended as a screening test in general practice. It still has a role where there are symptoms or where your GP judges it useful, and your GP will explain why if they suggest it.
What changed in 2026
Australia’s clinical guidance on PSA testing was updated in 2026, following approval of a revised guideline. The direction of travel is towards more structured, better explained testing for men who want it, and clearer pathways for what happens after a raised result.
Two practical changes are worth knowing about. First, the guidance is clearer that a raised PSA should generally lead to an MRI before any decision about biopsy, rather than straight to biopsy — which spares a lot of men an unnecessary procedure. That MRI is arranged through a specialist rather than ordered directly by your GP.
Second, the thresholds that prompt further investigation are read against your age and your risk rather than one universal cut-off. What your GP does with a result depends on how old you are, what your previous readings were, and what else is in your history.
What has not changed
- There is no national prostate screening program in Australia. Testing is a decision you make with your GP.
- The conversation matters as much as the test. What a result would mean, and what you would want to do about it, are worth thinking about before the blood is taken.
- For men at average risk, the guidance is an informed discussion and, if you choose to test, a PSA test every two years between 50 and 69. Men at higher risk are offered testing every two years from 45.
- There is a point at which testing stops being useful, based on age and general health. Your GP will raise it.
Because this guidance is recent and applies differently to different men, the specifics are best worked through in an appointment rather than read off a page. See our men’s health page.
If you are at higher risk
Some men should start the conversation earlier and have it more often. Bring it up if any of the following apply to you:
- A father or brother with prostate cancer, particularly if diagnosed young.
- More than one relative with prostate cancer.
- A known BRCA2 gene variant, or a family history of breast, ovarian or pancreatic cancer that suggests one.
- Black or sub-Saharan African ancestry, which the guidance identifies as higher risk.
- Aboriginal and Torres Strait Islander men — the same age and risk recommendations apply, and your GP can tailor the conversation to your circumstances.
Family history is one of the strongest signals we have, and it is the sort of thing men often do not think to mention. If your dad had prostate cancer, tell your GP even if it feels like ancient history.
Symptoms worth an appointment regardless
Testing decisions are for men without symptoms. If you have symptoms, that is a different appointment and it should not wait for a discussion about screening.
- Needing to pass urine more often, particularly at night.
- Difficulty starting, a weak stream, or dribbling at the end.
- A feeling that the bladder has not emptied.
- Blood in the urine or semen.
- Pain or burning when passing urine.
- New pain in the back, hips or pelvis that does not settle.
Most of these turn out to be an enlarged prostate or an infection rather than cancer — but they are all worth sorting out, and several of them are easily treated once identified.
How the appointment works here
Book a standard appointment and say you would like to talk about prostate testing. Your GP will take a history, ask about family history and symptoms, and talk through what a test would and would not tell you.
If you decide to go ahead, the blood test is collected on site. Results usually come back within a few days and we aim to contact you to discuss them. If you have not heard, call us. If a result needs following up, your GP will explain the options and arrange referral where that is the right step. See referrals.
Men over 40 often find it useful to combine the conversation with a broader check — blood pressure, cholesterol, blood sugar, weight, alcohol, mood and sleep. It is one appointment and it covers the things most likely to matter. See health assessments.
This article is general information for people in the Gosford and Central Coast area. It is not advice about your situation and it does not replace a consultation with your own doctor. If you are worried about a symptom, book an appointment or call us on (02) 4311 3800. In an emergency, call 000.
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