Some of the world's top prostate cancer specialists have endorsed PSA testing as a useful early detection tool.
In an announcement at the Prostate Cancer World Congress in Melbourne on Wednesday, they said there was strong evidence in favour of testing men aged 50 to 69.
They hoped what they called the Melbourne consensus would clarify confusion about screening and treatment.
A key element of their consensus was that not all diagnoses should lead to treatment.
"Many men with low-risk prostate cancer do not need aggressive treatment," said the statement, signed by specialists from several countries.
"Active surveillance protocols have been developed and have been shown to be a reasonable and safe option for many men with low-volume, low-risk prostate cancer."
Another key element is open communication.
"The decision to undergo PSA testing should be shared between patient and doctor, and men should be well counselled about the harms and benefits of early detection," said Professor Tony Costello, director of Urology at the Royal Melbourne Hospital and a key signatory to the statement.
"No man should be denied PSA testing," he said.
"Advances in medical science and clinical protocols are reducing the risk of over-diagnosis and over-treatment.
"We support the rational use of PSA testing to predict the risk of prostate cancer, followed by active surveillance to ensure all men benefit from early detection and lower death rates."
The experts emphasised PSA testing should be part of a broader strategy.
Rectal examination, taking a family history and considering a patient's ethnicity were also important.
The statement said it was useful for men in their 40s to have a PSA test to help predict their future risk.
While agreeing with some parts of the statement, Cancer Council Australia said the consensus was not backed by definite evidence-based literature.
"It would be helpful to separate the diagnosis from treatment to avoid over-treatment of prostate cancers which would never have caused problems in the man's lifetime," said council CEO Professor Ian Olver.
"However, this separation is difficult because often men fearful of prostate cancer want immediate treatment.
"Until now over-diagnosis has led to over-treatment and over-treatment leads to side effects such as impotence and incontinence without benefit."
He said the ultimate goal was a better test to accurately diagnose prostate cancer and predict the aggressiveness of the disease.
The Prostate Cancer Foundation welcomed the consensus.
CEO Dr Anthony Lowe said it was an important step in clarifying the issue for Australian men.
"We have consistently urged men who are over 50 years, or 40 years with a family history, to talk to their doctor.
"The consensus statement is clear in saying there is now strong evidence that PSA testing reduces the risk of metastatic prostate cancer and of death from prostate cancer among this group."
He said the foundation was working with Cancer Council Australia and other interest groups to develop evidence-based clinical guidelines.
