Prostate Cancer in Australia and New Zealand: Early Detection, Screening and What Patients Should Know

 

Prostate cancer is one of the most commonly diagnosed cancers affecting men in Australia and New Zealand. Early detection through prostate health awareness and appropriate screening, including prostate-specific antigen (PSA) testing, plays an important role in identifying the disease at a stage where treatment options and outcomes are often more favourable.

Thousands of men in Australia and New Zealand are diagnosed with prostate cancer each year. It remains one of the most commonly diagnosed cancers in men and a leading cause of cancer-related mortality.^i,ii Current data indicate that approximately 1 in 6 men will be diagnosed with prostate cancer during their lifetime.ⁱⁱⁱ In Australia, prostate cancer accounts for 16% of all cancers diagnosed and 13% of all male cancer-related deaths. Each year, more than 26,000 men are diagnosed and more than 3,900 die from the disease.^iv

Early detection of the disease is associated with significantly improved outcomes, with five-year survival rates exceeding 99% when diagnosed at stage 1.ⁱ However, many cases are not identified at this early stage.

Outcomes are often more favourable when prostate cancer is detected early, with greater opportunity to consider management approaches that aim to preserve quality of life. In contrast, more advanced disease may require broader treatment strategies that can have a greater impact on daily functioning and overall wellbeing.

Evolving guidance on early detection in Australia

In Australia, national guidance on early detection continues to evolve in response to advances in clinical practice. In early 2025, the Prostate Cancer Foundation of Australia (PCFA) released the Draft 2025 Guidelines for the Early Detection of Prostate Cancer in Australia for public consultation. The consultation period provided clinicians, consumers, and other stakeholders with the opportunity to review and provide feedback on the proposed recommendations. Final approval by the National Health and Medical Research Council (NHMRC) is still pending.

The draft updates aim to replace the 2016 PSA Testing Guidelines and reflect developments in diagnostic imaging, biopsy techniques, genetic risk assessment, and active surveillance strategies. 

Proposed changes include: 

• Baseline PSA testing from age 40 – men interested in prostate health could be offered an initial test at 40.
• Two-yearly PSA testing for men aged 50–69 – supported by GP-led discussions on benefits and risks.
• Earlier testing for high-risk men – including those with a family history, BRCA2 mutations, or sub-Saharan ancestry.
• Aboriginal and Torres Strait Islander men – recommended PSA testing every two years from age 40.
• Diagnostic pathway changes – routine digital rectal examinations in primary care no longer recommended; multiparametric MRI (mpMRI) before biopsy advised.
• Management and surveillance – reinforced guidance for active surveillance in low-risk disease to reduce overtreatment.

Barriers to early detection

One challenge in the early detection of prostate cancer is that the condition can develop without noticeable symptoms in its initial stages. In many instances, there are no clear clinical signs until the disease has progressed. When symptoms do occur, they are often non-specific and may be attributed to other, more common conditions.

These behavioural and clinical factors can influence the timing of diagnosis and subsequent management decisions.

Attitudes and perceptions towards screening

A study^v exploring male perceptions and attitudes towards prostate cancer awareness found that many participants perceived their personal risk to be low, particularly in the absence of symptoms.

Several respondents referred to aspects of “Australian masculinity” as influencing their reluctance to seek screening or medical advice. The same study also identified an association between the quality of a patient’s relationship with their general practitioner and the likelihood of participating in prostate cancer screening.

Although some of these attitudes may appear outdated, similar behavioural patterns continue to be observed in other areas of men’s health, including mental wellbeing, particularly among younger men.^vi Improving awareness and normalising conversations about men’s health may contribute to more timely engagement with healthcare services.

So, what can be done by the healthcare profession to support earlier engagement in care?

Education and awareness

Reducing stigma around prostate cancer and encouraging open discussion about men’s health are important steps in supporting earlier engagement. Respectful, evidence-based conversations can help create a supportive environment in which patients and their families feel comfortable raising concerns and asking questions. This approach enables individuals to better understand their personal risk and available options within a clinical setting.

A structured communication framework^vi has been developed to support healthcare professionals in initiating meaningful discussions with patients about prostate health. The framework emphasises collaborative, patient-centred engagement and highlights the importance of ongoing professional development in communication skills.

It recommends tailoring conversations to the individual patient, taking into account factors such as health literacy, cultural background, and current health behaviours. Where appropriate, a multidisciplinary approach may also be considered to ensure comprehensive and coordinated care.

In practice and hospital environments, guiding patients towards reliable educational resources can further support informed decision-making.

For those seeking further information, ProstateCancerTreatment.org offers educational content relevant to Australia and New Zealand on prostate cancer awareness, diagnostic considerations, and treatment pathways. The platform aims to support informed conversations between individuals and their healthcare professionals and to encourage balanced, evidence-based discussion within a clinical setting.

 

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ⁱ Better Health Channel. Prostate cancer. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/prostate-cancer [Accessed February 2026]
ⁱⁱ Prostate Cancer Foundation NZ. Useful links. Prostate cancer – key facts. https://prostate.org.nz/useful-links [Accessed February 2026]
ⁱⁱⁱ Australian Prostate Cancer, Awareness and Statistics, https://australianprostatecancer.org.au/about-prostate-cancer/awareness-and-statistics/ [Accessed February 2026]
^iv Draft 2025 Guidelines for the Early Detection of Prostate Cancer in Australia: Technical Report. Prostate Cancer Foundation of Australia, June 2025. Available at: Prostate Cancer Foundation of Australia.
^v Kannan A, Kirkman M, Ruseckaite R, Evans SM. Prostate cancer awareness, case-finding, and early diagnosis: Interviews with undiagnosed men in Australia. PLoS One. 2019 Mar 7;14(3):e0211539. doi: 10.1371/journal.pone.0211539. PMID: 30845152; PMCID: PMC6405086.
^vi White SJ, Condon B, Ditton-Phare P, Dodd N, Gilroy J, Hersh D, Kerr D, Lambert K, McPherson ZE, Mullan J, Saad S, Stubbe M, Warren-James M, Weir KR, Gilligan C. Enhancing effective healthcare communication in Australia and Aotearoa New Zealand: Considerations for research, teaching, policy, and practice. PEC Innov. 2023 Sep 26;3:100221. doi: 10.1016/j.pecinn.2023.100221. PMID: 37822775; PMCID: PMC10562187.

Disclaimer:
The content of this editorial is intended for informational purposes only and should not be considered medical advice. Treatment options and outcomes may vary based on individual patient needs and clinical circumstances. Healthcare professionals should always be consulted for personalised medical advice before pursuing any diagnosis, treatment, or medical procedure.