Lessons from the implementation of the Australian 2016 prostate specific antigen testing clinical practice guidelines : A descriptive study

Introduction
In 2025, prostate cancer is the most common cancer in Australia, regardless of gender, and is the second most common cause of cancer death despite the opportunities for cure. In 2016, Australian Clinical Practice Guidelines for Prostate Specific Antigen (PSA) testing were published to improve early detection and management of prostate cancer. This study reports on a public consultation into the implementation and impact of these guidelines on prostate cancer diagnosis and outcomes.

Methods
Thematic analysis of responses from a public consultation conducted in accordance with best-practice guideline development processes. A national Call for Submissions, using a coordinated public notification strategy, was made, inviting consumers with an interest in PSA testing for prostate cancer to share their experiences via an online platform. Seven questions were posed to all respondents.

Results
Consumers described the 2016 Guidelines as ineffective based on negative message framing, lack of uptake of the guidelines by key primary care groups, and low community awareness. Although a small number of men reported that they were able to access early detection and subsequent curative treatment, the majority of men reported missed opportunities for testing, resulting in diagnoses with late-stage disease. Suggestions for future successful implementation included a consumer companion to the guidelines, regular guideline review, a national education and awareness program, and targeted education for health professionals.

Conclusions
Australia's future response to the growing burden of prostate cancer rests on key stakeholders across the health system to ensure alignment and compliance with updated Guidelines. Effective implementation of such guidelines in the future requires a well-resourced education and awareness program for both the lay and clinician communities, and consistency in adoption and practice across key medical groups.

© 2025 The Author(s). ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.

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