Quick answer
What is a PSA test?
A PSA test is a blood test that may indicate prostate problems, including cancer, but the level can also be raised for benign reasons such as an enlarged prostate. There is no national PSA screening programme in the UK, so men over 50 are encouraged to discuss the pros and cons with a GP before testing.
What a PSA test measures
A PSA test measures a protein made by the prostate gland that is present at low levels in the blood. A raised PSA level is not specific to cancer, since several benign conditions can also cause it to rise.
Who should consider PSA testing
Men aged 50 and over are generally the ones who consider PSA testing, and this is usually done after a discussion with a GP about the benefits and limitations. Men in higher-risk groups, such as those with a family history of prostate cancer or Black men, may be advised to consider testing at a younger age.
Limitations of the PSA test
The PSA test can produce false positives, which raises concerns about overdiagnosis and unnecessary follow-up investigations. It can also produce false negative results, meaning it does not always pick up prostate cancer when it is present.
What happens if your PSA result is raised
A raised PSA result usually leads to a specialist assessment pathway rather than an immediate diagnosis. An MRI scan is increasingly used before a biopsy is considered, to help decide whether further investigation is needed.
Common questions about the PSA test
- Should all men have a PSA test?
- PSA testing is an informed choice rather than something recommended for every man, because the benefits and harms need to be weighed up individually. There is no universal screening programme, so this decision is usually made together with a GP.
- What can cause a raised PSA level?
- A raised PSA level can be caused by prostatitis, an enlarged prostate, recent ejaculation, cycling, or prostate cancer. Because there are so many possible causes, a raised result on its own does not confirm cancer.
- What happens if your PSA level is raised?
- If your PSA level is raised, you may be offered a repeat test, an MRI scan, or a specialist referral for possible biopsy. This follows a specialist assessment pathway rather than an immediate diagnosis.
- What symptoms need assessment regardless of PSA result?
- Urinary symptoms and blood in the semen should always be checked by a GP, whatever your PSA result shows. These symptoms can have several causes and are worth assessing in their own right.