PSA Testing and Prostate Cancer

Any man can make an appointment with their GP to discuss having the prostate specific antigen (PSA) test. The test is available to anyone with a prostate, including trans women and non-binary people.

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.

The PSA test and what the results might mean

The image below shows that the prostate gland releases PSA molecules into the blood. 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.

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.

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 a number of 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.

Test results and follow-up

If you have a raised PSA level you may be offered another PSA test to check if it remains high.

Your GP may then discuss referral to a specialist (urologist) with you. You may have further investigations, such as a magnetic resonance imaging (MRI) scan of the prostate. Depending on the MRI result, you may then need a biopsy. A biopsy involves taking small samples of your prostate, usually through your back passage or perineum (the skin just in front of the anus), and checking them for cancer.

If further investigations show you have prostate cancer, your specialist will discuss the most appropriate follow-up for you. Regular follow-up (also known as monitoring or surveillance) can be an option for many men who have cancer confined to the prostate gland. Regular follow-up can include blood tests, clinical examination, MRI imaging scans and biopsies. Other options can include surgery, radiotherapy and hormone therapy.

Treatment options for faster growing or advanced cancers include hormone therapy, biopsies and chemotherapy.