The PSA Test: Making an Informed Choice

Key Information

• The Goal: We want to remove the barriers that stop men from getting tested. You do not need to have a digital rectal examination just to request a PSA blood test.
• Our Campaign: We have developed a straightforward, patient-friendly process to help men over 45 who are worried about prostate cancer and have not had a PSA test in the past two years.
• What is the PSA Test? It is a simple blood test that measures a protein made by the prostate gland. A raised level can be a sign of a problem, such as an enlarged prostate or, less commonly, prostate cancer.

Should I Get Tested?

Your journey to considering this test usually starts in one of two ways. Both are valid starting points.

• 1. You Have Symptoms: You may have noticed changes in your waterworks, such as needing to pass urine more often, especially at night, difficulty starting to pass urine, or new erectile difficulties.
• 2. You Are Being Proactive: You may have no symptoms at all, but you are over 45 and want to be proactive about your health.

Understanding the Limitations

It is important to understand that the PSA test is not perfect.

• False Positives: Your PSA level can be raised for many reasons that are not cancer, such as recent strenuous exercise, sexual activity, or natural enlargement of the prostate as you get older.
• False Negatives: PSA can sometimes be normal even when cancer is present.

Because of this, the NHS does not offer routine screening for men over 50 without symptoms. Instead, we support you in making an informed choice. We will always discuss the benefits and potential downsides with you first, so you can decide if it is the right step for you.

Preparing for Your Test

If you decide to go ahead, the process is straightforward. It involves a standard blood test done here at the surgery.

To make the result as accurate as possible, please follow these rules:

• For 48 hours before the test: Avoid strenuous exercise and ejaculation.
• Food and Drink: You do not need to fast. You can eat and drink as normal.

What Happens Next?

Your results are usually back within one to two weeks. If you have not heard from us by then, please contact us.

If your PSA level is raised, the most important thing to know is that this does not automatically mean you have cancer.

• Our first step will be to discuss the result with you.
• We may suggest repeating the test to see if the level is still raised.
• If it remains raised, we would then talk about referring you to a specialist for further investigations, such as an MRI scan.

Frequently Asked Questions

I’m under 50. Do I need a PSA test?

For most men, PSA testing is not recommended under the age of 50.

However, you may be at higher risk if you have a first-degree relative (such as a father or brother) diagnosed with prostate cancer before the age of 65, or if you are Black, as risk is higher in Black men.

If you are concerned about this, please contact us.

What are the symptoms of prostate cancer?

Early prostate cancer often causes no symptoms at all.

When symptoms do occur, they may include:

• Difficulty starting or stopping urination.
• A weak urine stream.
• Needing to urinate more often, especially at night.
• Blood in the urine or semen.
• Pain in the hips, pelvis, or lower back, more often in advanced disease.

Some of these symptoms can also be caused by non-cancerous conditions, such as benign prostate enlargement, so if any of these symptoms resonate with you, it is important to contact us.

How does a GP examine the prostate?

A prostate examination, also called a digital rectal examination, involves the GP gently inserting a gloved finger into the rectum to feel the prostate.

We would check for any unusual lumps, hardness, or asymmetry. The test usually takes under a minute and should not be painful. It is optional.

What does a prostate examination add to a PSA test?

While a PSA blood test can detect raised protein levels, it is not always accurate.

Some cancers do not raise PSA, and some men have raised PSA for other reasons.

A prostate examination adds a physical assessment, which can sometimes detect abnormalities the PSA test might miss.

However, it is not essential for initial testing in men with no symptoms, so it is optional.

How common is prostate cancer?

Prostate cancer is the most common cancer in men in the UK.

Around 1 in 8 men will be diagnosed with prostate cancer in their lifetime.

Risk increases with age. It is also more common in Black men and in those with a family history.

If I’m diagnosed with prostate cancer, does that mean I’ll die from it?

Not necessarily.

Many prostate cancers are slow growing and may never cause harm.

Over 80% of men diagnosed with prostate cancer survive 10 years or more.

Many men with prostate cancer live with it rather than die from it.

The key is understanding what type of cancer you have and what treatment, if any, is needed. That starts with early, informed testing.

Why isn’t there an NHS screening programme for prostate cancer like there is for breast or bowel cancer?

Unlike those cancers, the PSA test does not meet all the criteria for a national screening programme.

This is because:

• The PSA test is not specific to cancer.
• It can lead to false positives, unnecessary worry, and sometimes treatment for cancers that may never have caused problems.
• It can also miss some aggressive cancers.

That is why men are encouraged to make an individual, informed decision rather than being offered blanket national screening.

Do I also need to have a rectal examination?

This is a very common question.

No, you do not have to have a rectal examination to be referred for prostate cancer tests.

New advice from prostate cancer specialists, including the British Association of Urological Surgeons and Prostate Cancer UK, says this is no longer necessary in most cases.

If your PSA blood test is raised, that is now enough to refer you for further tests, such as an MRI scan. These scans are more accurate than a rectal examination and do not involve a physical examination.

You can still choose to have a rectal examination if you want one, but it is completely optional.

Request Your Test

The PSA test is a useful tool, but it is only one piece of the puzzle. Whether you have symptoms or are simply considering the test because of your age, the most important step is discussing it with us.

We have plenty of nurse appointments available to help you get the test done quickly.

Last reviewed: 15 April 2026
Next review due: 15 April 2029