There's currently no screening programme for prostate cancer in the UK. This is because it has not been proved that the benefits would outweigh the risks.
PSA screening
Routinely screening all men to check their prostate-specific antigen (PSA) levels is a controversial subject in the international medical community. There are several reasons for this.
PSA tests are unreliable and can suggest prostate cancer when no cancer exists (a false-positive result). Most men are now offered an MRI scan before a biopsy to help avoid unnecessary
tests, but some men may have invasive, and sometimes painful, biopsies for no reason.
Furthermore, around 1 in 7 of those with normal PSA levels may have prostate cancer (a false-negative result), so many cases may be missed.
The PSA test can find aggressive prostate cancer that needs treatment, but it can also find slow-growing cancer that may never cause symptoms or shorten life. Some men may face difficult decisions about treatment, although this is less likely now that most men are offered an MRI scan before further tests and treatment
Treating prostate cancer in its early stages can be beneficial in some cases, but the side effects of the various treatments are potentially so serious that men may choose to delay treatment until it's absolutely necessary.
Although screening has been shown to reduce a man's chance of dying from prostate cancer, it would mean many men receive treatment unnecessarily.
More research is needed to determine whether the possible benefits of a screening programme would outweigh the harms of:
- overdiagnosis – people being diagnosed with a cancer that would never cause symptoms or shorten life expectancy
- overtreatment – people being treated unnecessarily for tumours that would unlikely be harmfulShould you know your PSA level?
Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test.
If you're aged 50 or over and decide to have your PSA levels tested, this can arranged.
If results show you have a raised level of PSA, a GP may suggest further tests.
PSA Tests
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. Some of it leaks into your blood, but how much depends on your age and the health of your prostate.
There's currently no national screening programme for prostate cancer in the UK because the PSA test is not always accurate.
Before deciding to have the PSA test, you may want to talk to a GP or practice nurse, as well as your partner or a friend or family member.
You have a higher risk of prostate cancer if you:
- have a family history of prostate cancer
- are of black ethnic origin
- are overweight or obese
What's a raised PSA level?
The amount of PSA in your blood is measured in nanograms of PSA per millilitre of blood (ng/ml).
If you're aged 50 to 69, raised PSA is 3ng/ml or higher.
A raised PSA level in your blood may be a sign of prostate cancer, but it can also be a sign of another condition that's not cancer, such as:
an enlarged prostate
prostatitis
urinary tract infection
How accurate is the PSA test?
Research has shown around 3 in 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.
Pros and cons of the PSA test
Pros:
- it may reassure you if the test result is normal
- it can find early signs of cancer, meaning you can get treated early
- PSA testing may reduce your risk of dying if you do have cancer
Cons:
- it can miss cancer and provide false reassurance
- it may lead to unnecessary worry and medical tests when there's no cancer
- it cannot tell the difference between slow-growing and fast-growing cancers
- it may make you worry by finding a slow-growing cancer that may never cause any problems
Before having the test
If you're having a PSA test, you should not have:
- ejaculated in the past 48 hours
- exercised heavily in the past 48 hours
- a urinary infection
- had a prostate biopsy in the past 6 weeks
Each of these may give an inaccurate PSA reading.
Please note information on this page has been taken from the NHS 111 website. Before having a PSA blood test you will be required to confirm that you have read and understood the information provided on this webpage, including the section in green above about the things you should not have done prior to having the blood test. You will be sent a text message asking you to confirm this. Without this confirmation it will not be possible to complete the PSA test for you.