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Prostate screening discussion and PSA testing
Category: Screening Tests · All screening tests
What it is
The PSA test measures prostate-specific antigen in blood. Unlike mammography or bowel screening, there is no national prostate screening programme in the UK because PSA's benefits and harms are finely balanced; instead, men over 50 (or younger with risk factors) can request a PSA test after an informed discussion of pros and cons — an approach called informed choice.
Why it is done
PSA testing can find prostate cancers earlier, including some aggressive ones. But it also finds slow-growing cancers that would never have caused harm (overdiagnosis), leading to biopsies and treatments with side effects, and it can miss cancers or be raised by benign conditions.
How to prepare
Before testing, avoid ejaculation and vigorous cycling for about 48 hours and ensure any urine infection is treated, as these raise PSA. Tell your clinician about prostate medicines (finasteride/dutasteride lower PSA readings substantially) and recent prostate procedures.
What happens during the procedure
The test is a standard blood draw. An abnormal-feeling prostate on examination matters independently of PSA. If PSA is raised for your age, it is usually repeated after an interval before decisions, and modern pathways use MRI before biopsy.
Afterwards — recovery & results
Results are discussed in context: many raised PSAs are due to benign enlargement or inflammation. A normal PSA is reassuring but not a guarantee. Together with your clinician you decide on repeat testing intervals, MRI referral, or watchful waiting.
Risks & considerations
No physical risk from the blood test. The harms lie downstream — anxiety, biopsies and over-treatment — which is exactly why the informed discussion comes first. Decision aids are available to help you weigh your own priorities.
Related guides on MedicalVideos.com
Frequently asked questions
Why is there no screening programme if PSA exists?
Population trials show a small reduction in prostate cancer deaths offset by substantial overdiagnosis and treatment harm. Policy bodies judge the balance differently for populations than for an informed individual — hence the individual-choice route.
What PSA is 'normal'?
Age-related ranges are used (higher with age). A single value is interpreted with prostate size, examination, medicines and trend — your clinician will contextualise your number.
Related procedures — Screening Tests
Browse the P section of the A–Z list or return to the Procedures & Tests hub.