What is PSA?

It is a blood test which measures the amount of Prostate Specific Antigen in your blood (PSA).  Normal cells in the prostate produce the protein PSA, so it is normal for all men to have detectable PSA levels.  As men get older, the level of PSA naturally rises.

Is the PSA test a screening test for prostate cancer?

No unfortunately not.  To be a true screening test, such as the bowel cancer screening, certain criteria have to be met.  The one the PSA test falls down on is that it is not accurate enough, there are too many false positives.  This is because the PSA level can go up for other non-cancer reasons, such as an infection or enlarged prostate gland. In fact 76% of men with a raised PSA do not have cancer.

Advantages of PSA test

  • A PSA test can help to detect prostate cancer before you have any symptoms
  • The aim is to pick up cancers early as treatment is more likely to be successful. A PSA may pick up a fast growing cancer at an early stage.
  • There are some slow growing cancers which might not need treatment, just a watchful eye.  This would include regular check-ups and PSA levels.
  • Some men, who are more at risk of prostate cancer may benefit from having regular PSA checks to detect any changes early.

Disadvantages of PSA test

  • You could have a raised PSA even if you don’t have prostate cancer.
  • Should your PSA level be raised more tests may be required to determine the cause, one of which may be a biopsy.  All procedures carry risks, a prostate biopsy could increase the risk of pain, infection and blood in the urine or semen.
  • A PSA test can also miss prostate cancer.  2% of men, 1 in 50, who have a fast growing cancer will have a normal PSA test.
  • You could be diagnosed with a slow growing cancer which would never have impacted on your life, with no symptoms. However once you receive the diagnosis, you may wish to receive treatment which can cause side effects when in actual fact you do not need it.

Please see the attached leaflet for more information regarding PSA testing in men who have no symptoms –

PSA Testing: patient info sheet March 2022

The team at University Hospital Southampton are piloting a project where men can self refer for testing should they have symptoms or are deemed to be high-risk.  This self-referral can be made by emailing prostatehealthtest@uhs.nhs.uk they will receive an automated response with information and a prostate cancer risk assessment questionnaire.

If they wish to proceed to testing they can request an appointment for a PSA test and nurse-led urinary assessment.

If this assessment highlights the need for further investigation, an MRI will be performed to determine if a cancer is present or advice and treatment of urinary symptoms will be provided.


Further information on symptoms associated with prostate cancer can be found here.