What is the PSA blood test?The PSA test is a blood test that measures the amount of prostate specific antigen (PSA) in your blood. PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells. It’s normal to have a small amount of PSA in your blood, and the amount rises slightly as you get older and your prostate gets bigger. A raised PSA level may suggest you have a problem with your prostate, but not necessarily cancer. Show
Understanding the PSA blood test bookletThis booklet is for men who are thinking about having a PSA test. Download or order booklet Who can have a PSA blood test?You have the right to a PSA test if you’re over 50 and you’ve thought carefully about the advantages and disadvantages. If you’re black or you have a family history of prostate cancer, this can increase your own risk – so you may want to speak to your GP about having a PSA test from the age of 45. You may also be offered a PSA test if you have symptoms of a possible prostate problem. Some men are offered a PSA test as part of a general check-up. You should still think about the advantages and disadvantages and whether the test is right for you before agreeing to have one. What could affect my PSA level?Prostate specific antigen (PSA) is produced by healthy cells in the prostate, so it’s normal to have a small amount of PSA in your blood. The amount rises as you get older because your prostate gets bigger. Prostate problems, such as an enlarged prostate, prostatitis or prostate cancer, can cause your PSA level to rise – but lots of other things can affect your PSA level too, including the following.
Having a PSA blood testYou can have a PSA test at your GP surgery. Your GP or practice nurse might talk to you about having a PSA test if you're worried about prostate problems, if you’re at increased risk of getting prostate cancer, or if you have symptoms such as problems urinating. What will happen at the GP surgery?If you don't have any symptoms, your GP or practice nurse should talk to you about the advantages and disadvantages of the PSA test before you decide whether to have one. You should tell them if anyone in your family has had prostate or breast cancer. Your GP or practice nurse will also talk to you about your general health and any other health problems. If you have a serious health problem that means you wouldn't be fit enough for treatment for prostate cancer, or if treatment wouldn’t help you to live longer, your GP may not recommend having a PSA test unless you have symptoms of a possible prostate problem. If you decide you want a PSA test, your GP may also suggest doing a digital rectal examination (DRE) – sometimes known as a physical prostate exam – and a urine test to rule out a urine infection. What does the PSA blood test involve?A sample of your blood is taken and sent to a laboratory to be tested. The amount of PSA in your blood is measured in nanograms (a billionth of a gram) per millilitre of blood (ng/ml). You can eat and drink as normal before having a PSA test. It can take one to two weeks to get your test results. PSA blood testing in the community You may see PSA tests being offered in places such as community centres or football stadiums. If you’re thinking about having a PSA test at this type of event, make sure a doctor or nurse will be there to give you information and support. If you can, it’s usually best to visit your GP if you’re thinking about having a PSA test. If you do have a PSA test in the community you should visit your GP to discuss the results, especially if you have a raised PSA level. What will the test results tell me?Lots of things can cause a raised PSA level, including the following prostate problems:
So a PSA test alone can’t usually tell you whether you have prostate cancer. Many men with a raised PSA level don't have prostate cancer. And some men with a normal PSA level do have prostate cancer. To decide whether you need to see a specialist at the hospital, your GP will look at:
What happens next?If your GP thinks your PSA level is higher than it should be for your own situation, they may arrange for you to see a specialist at the hospital. For example, they might make an appointment for you to see a specialist if your PSA level is 3 ng/ml or higher. But this is just a guide and slightly higher levels may be normal in older men. They might refer you to a specialist if your PSA level is lower than 3 ng/ml but you have an increased risk of prostate cancer for other reasons, such as your family history. If your GP thinks you could have prostate cancer, you will usually see a specialist within two weeks. You may hear this called a 'two-week wait' or 'fast-track' referral. If your GP thinks something else has caused your PSA level to be raised, they might suggest having another PSA test in the future to see if your PSA level changes, rather than seeing a specialist straight away. Your GP should discuss all of this with you, to help you decide what to do next.
Regular PSA blood testsAfter some men have had their first PSA test they might want to have regular tests every few years, particularly if they have an increased risk of prostate cancer. This might be a good way to spot any changes in your PSA level that might suggest prostate cancer. But we need more research to show how often you might need a test. You could discuss this with your GP or practice nurse, or call our Specialist Nurses. You can order a PSA card to keep a record of your PSA level. Advantages and disadvantages of the PSA blood testIt’s important to think through the advantages and disadvantages of the PSA test. Having a PSA test is a personal decision – what might be important to one man may be less important to another. Advantages
Disadvantages
Should I have a PSA blood test?Deciding whether or not to have a PSA test can be difficult. Before you decide, try asking yourself the following questions, or discuss them with your GP or practice nurse.
It might help to talk this over with your partner, family or friends. If you want to discuss the test, call our Specialist Nurses. They can help you understand your own risk of prostate cancer and talk you through the advantages and disadvantages of the PSA test. You may also find it helpful to fill out this information sheet. It has space to write down any risk factors or symptoms you have and lists questions you might want to ask your GP. You could have the sheet in front of you when you talk to your GP, to help guide your conversation. Worried about going to the GP?If you’re worried about your risk of prostate cancer or have any unusual symptoms, it's important to speak to your GP. It’s natural to feel worried or embarrassed about going to the doctor or having tests. But don’t let that stop you going to your GP. Remember, the tests give your GP the best idea about whether you have a problem that needs treating.
What if my GP won't give me a PSA blood test?You have the right to a PSA test if you’re over 50 and you’ve thought carefully about the pros and cons. If you then decide that you want a test, your GP should give you one. A PSA test isn't suitable for everyone. For example, your GP may not recommend it if your general health means you wouldn't be fit enough for treatment for prostate cancer, or if treatment wouldn't help you to live longer. If your GP doesn't agree to do a PSA test, ask them to explain why, as there may be a good reason. Explain that you are entitled to a PSA test under the NHS Prostate Cancer Risk Management Programme. It might help to print this webpage and take it to the appointment with you. You could also print and show them our information for GPs.
If you still can't get a PSA test, you could follow the NHS complaints procedure.
Make sure you include the following information in your complaint:
You can also get advice and support from Citizens Advice. If you’re not sure whether to make a complaint, get in touch with our Specialist Nurses. They can help you understand your risk of prostate cancer so that you can decide what to do next. What is a baseline PSA blood test?A baseline prostate specific antigen (PSA) test involves having a PSA test while your risk of getting prostate cancer is still low – for example in your 40s. The aim of a baseline PSA test is not to help diagnose prostate cancer. Instead, some research suggests that it could be used to predict how likely you are to get prostate cancer in the future. For example, if a man’s PSA level in his 40s is slightly higher than expected, he might have a higher risk of getting prostate cancer in the future. If the test suggests you're at higher risk, you and your doctor may decide to do regular PSA tests to spot any changes that might suggest prostate cancer. However, we don’t yet know exactly what PSA level in your 40s would suggest an increased risk of prostate cancer in the future, or how often you should have a PSA test after the baseline test. Because of this, baseline testing isn’t very common in the UK. For more information about baseline testing, speak to your GP. Why isn't there a prostate cancer screening programme?Screening programmes aim to find early signs of cancer in people who don’t yet have any symptoms. They invite all suitable people to have a test to find out if they are at risk. In the UK there are screening programmes for breast, cervical and bowel cancer. Finding cancer early means it could be treated in time to get rid of it before it causes any problems. There is currently no screening programme for prostate cancer in the UK. It’s important that the benefits of any screening programme outweigh the disadvantages. But it isn’t clear that screening all men with the PSA test would have more benefits than disadvantages. Some studies have found that screening with the PSA test could mean fewer men die from prostate cancer. But it would also mean that:
While the PSA test on its own isn't suitable as a screening test for prostate cancer, researchers are working to find a test, or combination of tests, that might be suitable in the future. Until then, the Prostate Cancer Risk Management Programme gives men over 50 the right to have a PSA test on the NHS – as long as they’ve thought carefully about the advantages and disadvantages. References and reviewersUpdated February 2021 | Due for Review: February 2024 List of references
List of reviewers
What is the most accurate blood test for prostate cancer?If your doctor determines you should undergo screening, he or she will most likely recommend the PSA test. For more than 30 years, the PSA test has been the gold standard in prostate cancer screening. This simple blood test measures how much prostate-specific antigen is in your blood.
Can prostate cancer be detected by blood test?The PSA test is a blood test to help detect prostate cancer. But it's not perfect and will not find all prostate cancers. The test, which can be done at a GP surgery, measures the level of prostate-specific antigen (PSA) in your blood. PSA is a protein made only by the prostate gland.
What is a normal PSA level?There is no specific normal or abnormal level of PSA in the blood. In the past, PSA levels of 4.0 ng/mL and lower were considered normal. However, some individuals with PSA levels below 4.0 ng/mL have prostate cancer and many with higher PSA levels between 4 and 10 ng/mL do not have prostate cancer (1).
Which two tests are done for prostate cancer?Two tests are commonly used to screen for prostate cancer:. A prostate-specific antigen test, also called a PSA blood test. PSA is a protein made by your prostate. ... . Digital Rectal Examination (DRE). The DRE is a prostate exam.. |