PSA Testing

A PSA test checks the level of prostate specific antigen (PSA) in your blood. High levels may be a sign of a prostate condition.

Testing may be recommended if you have symptoms that could indicate prostate cancer, such as:

  • peeing more than usual, having a sudden urge to pee or getting up often in the night to pee
  • blood in your pee
  • problems getting or keeping an erection

If you have any of these symptoms, we recommend you make an appointment with a doctor.

A National screening programme of PSA testing is not offered on the NHS.

Men aged 50 or over can ask their GP for a PSA test, even if they do not have symptoms.

The benefits and limitations of PSA testing is listed below:-

  •  Benefits of PSA testing include:
    • Early detection — PSA testing may lead to prostate cancer being detected before symptoms develop.
    • Early treatment or entry into an active surveillance programme — detecting prostate cancer early before it progresses to cause morbidity or limit life expectancy. 
  • Limitations and risks of PSA testing include:
    • False-negative PSA tests — about 15% of people with a normal PSA level (less than 3 nanograms/mL) may have prostate cancer, and 2% will have high-grade cancer. However, it is not known what proportion of these cancers become clinically evident.
    • False-positive PSA tests — about 75% of people with a raised PSA level (3 nanograms/mL or higher) have a negative prostate biopsy.
    • Unnecessary investigation — a false positive PSA test may lead to invasive investigations, such as prostate biopsy, and there may be adverse effects (for example bleeding or infection).
    • Unnecessary treatment — slow-growing tumours are common and may not cause any symptoms or shorten life. Some tested men may therefore face unnecessary diagnosis (overdiagnosis) of prostate cancer, as well as associated anxiety, medical tests, and treatments with adverse effects. 
    • There is a particular risk of over-diagnosing and overtreating prostatic cancer in men over the age of 79 where the prevalence is highest but the proportion of cancers which are clinically significant is lowest. For many patients in this group although they may have prostatic cancer it will not cause symptoms or impact their life expectancy. Tests and treatment may cause additional risks and anxiety.

A raised PSA level may mean you have prostate cancer but about two out of three men with a raised PSA level will not have prostate cancer.

Other conditions may also cause a raised PSA level, including:

  • Inability to pass urine, causing an enlarged bladder
  • Enlargement of the prostate that is non-cancerous (benign).
  • Older age.
  • Urine infection.
  • Acute prostatitis.
  • Recent bladder or prostate surgery or procedures.
  • If you have a tube (catheter) to help pass urine

If you wish to go ahead and have a PSA blood test then please book an appointment for a blood test.

Preparing for a PSA test

For 48 hours before your PSA test, do not:

  • have anal sex
  • ejaculate (come)
  • do anything that leaves you out of breath, such as exercise, in particular cycling or horse riding.

These can increase your PSA levels which could make the test less accurate.

You can eat and drink as usual before having a PSA test.

If your level is raised, then you will be asked to arrange an appointment with a doctor to discuss the results and an examination of your prostate may be needed.

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