The prostate specific antigen (PSA) test is a blood test that can help diagnose prostate problems including prostate cancer. It is not a perfect test. It will miss some prostate cancers, will detect some that would never go on to cause harm and can show a raised PSA level when there is no prostate cancer present.

This leaflet provides clear and balanced information that can help you decide if you want to have a PSA test or not. Before deciding, you may want to talk to your GP, practice nurse, partner, family members or friends.

PSA test

PSA is a protein that is made by prostate cells. It is measured using a blood test. Most men will not have a raised PSA level. PSA levels can be raised in several conditions, such as a urinary infection, an enlarged prostate, prostatitis or prostate cancer.

If you decide you want a PSA test, you should refrain from sexual activity and vigorous exercise, such as cycling, in the 2 days before the test as they can affect the PSA level.

Having a prostate biopsy or cystoscopy (where a small tube is inserted into the bladder) in the 6 weeks before the test may also affect the PSA level. 

The PSA test and what the results might mean

The PSA test measures the amount of PSA molecules in a patient’s blood.

It’s normal for all men to have some PSA in their blood. A raised PSA level can be a sign of prostate cancer, but it can be raised for lots of reasons including:

• a urinary or urinary tract infection (UTI)
• prostate stimulation, recent ejaculation, or anal sex
• recent vigorous exercise
• other prostate problems, such as an enlarged prostate

If you have a raised PSA, it doesn’t necessarily mean you have cancer. Your doctor should talk to you about your results and what they might mean.

How accurate is a PSA test?

Research has shown that around 3 and 4 men with a raised PSA level will not have cancer, and around 1 in 7 men with prostate cancer would have a normal PSA result.

Possible advantages

A PSA test can help pick up prostate cancer before you have any symptoms.

A PSA test can help pick up a fast-growing cancer at an early stage, when treatment could stop it spreading and causing problems or shortening your life.

Possible disadvantages

You might have a raised PSA level, without cancer. Many individuals with a raised PSA level do not have prostate cancer.

The PSA test can miss prostate cancer. A small proportion of men who have a low PSA level will later be found to have prostate cancer.

If your PSA level is raised, you may need a biopsy. This can cause side effects, such as pain, infection, and bleeding. Not all men will need to have a biopsy.

You might be diagnosed with a slow-growing cancer that would never have caused any problems or shortened your life. Being diagnosed with cancer could make you worry, and you might decide to have treatment you do not need. 

Treatments can cause side effects which can affect you daily for the rest of your life, such as urinary, bowel and erection problems.

Finally, please see this infographic to understand why there is no routine screening for prostate cancer in the UK. [EXTERNAL IMAGE LINK]

Before you decide whether to have the test, think about the information on this page.

Talk to your GP about the possible advantages and disadvantages of the test and your own risk of prostate cancer.

Having a PSA test is a personal decision - what might be important to one person may not be to another and having the test might not be the right thing for you.

Content abbreviated from NHS website and Cancer research UK, GOV.UK health information - visit these websites to see more original content.

More information is available at PCASO.