The PSA test is a blood test that can be used to help diagnose prostate cancer and other prostate problems. Your GP might suggest having a PSA test if you have any urinary problems, or if you're worried about your risk of prostate cancer.

Here we talk about who can have a PSA test, what will happen if you have a test, and what the results might mean.

There are advantages and disadvantages to having a PSA test. You’ll need to talk to your GP or practice nurse about these before deciding whether to have a test.

We also know that some men having trouble getting a PSA test. You can read more about what to do if this happens.

What is the PSA 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 is normal for all men to have a small amount of PSA in their blood, and this amount rises as you get older. A raised PSA level may suggest you have a problem with your prostate, but not necessarily cancer.

You can have a PSA test at your GP surgery. You will need to discuss it with your GP first. At some GP surgeries, you can discuss the test with the practice nurse, and they can do a test if you decide you want one.

Who can have a PSA test?

You have the right to have a PSA test if you’re over 50 and you’ve talked through the pros and cons with your GP or practice nurse. If you’re over 45 but have a higher risk of prostate cancer, you might want to talk to your GP about having a PSA test.

Your GP may not recommend the PSA test if you have other serious health problems which might cause you more problems than prostate cancer would. 

What can the PSA test tell me?

A raised PSA level can be a sign of a problem with your prostate. This could be:

Diagram of where the prostate is

Other things can also cause your PSA level to rise. 

A raised PSA level can be a sign of prostate cancer. But around three quarters of men (76 per cent) with a raised PSA level don’t have prostate cancer. And some men with a normal PSA level do have prostate cancer.

You may be more likely to get prostate cancer if:

  • you are aged 50 or over
  • you are Black
  • your father or brother has had it.

To decide whether you need to see a hospital specialist for more tests, your GP will look at more than just your PSA level. They will also look at your risk of prostate cancer and whether you’ve had a prostate biopsy in the past. They will also do an examination of your prostate called a digital rectal examination (DRE).

Having a PSA test

You can have a PSA test at your GP surgery. Your GP or practice nurse should talk to you about the pros and cons of the PSA test before you decide to have one. They will also discuss your risk of prostate cancer, and ask you about any symptoms you might have.

Your GP or practice nurse will also talk to you about your general health and other health problems. They might not recommend a PSA test if you have other serious health problems which might cause you more problems than prostate cancer would.

If you decide you want a PSA test, your GP or practice nurse will take a sample of blood which is 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).

Your GP may also do a digital rectal examination (DRE), and a urine test to rule out a urine infection.

What if my GP won’t give me a PSA test?

If you’re over 50 and have discussed the pros and cons of the PSA test with your GP or practice nurse, and decide that you want to have one, they should give you a PSA test. But we know that some men have trouble getting the test. There are things that you can do if your GP or practice nurse won’t give you a test.

  • Explain that you are entitled to a PSA test under the Prostate Cancer Risk Management Programme. You might also like to print and show them a copy of our information for GPs.
  • If they still say no, try speaking to another GP or practice nurse.
  • If they also say no, speak to the practice manager at your GP surgery.
  • Your GP surgery should have information about its complaints procedure. You can follow this procedure, or write to the GP or practice manager explaining your complaint.

If you still have trouble getting a PSA test, you could make a complaint through the NHS complaints procedure.

  • If you live in England, you can complain to NHS England. NHS Choices has more information.
  • If you live in Scotland, you can make a complaint to your local health board. Get more information from NHS National Services Scotland.
  • If you live in Wales, you can make a complaint to your local health board. Health in Wales has more information.
  • If you live in Northern Ireland, you can make a complaint to the health and social care board. Get more information from nidirect.

Make sure you include the following information in your complaint:

  • your name
  • your contact details – such as your home address, telephone number or email address
  • a clear description of your complaint – including what happened, where and when
  • details of any relevant conversations, letters or emails you've had.

You can get advice and support about making a complaint from your local Citizens Advice Bureau.

If your GP or practice nurse won't give you a PSA test and 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 could affect my PSA level?

PSA is produced by healthy cells in the prostate, so it’s normal for all men to have a small amount of PSA in their blood. There are other things that can raise your PSA level.

  • A urine infection – you will have treatment for any infection, and will need to wait around four to six weeks until the infection has cleared up before you have a PSA test.  
  • Vigorous exercise – especially cycling – in the 48 hours before a PSA test.
  • Ejaculation in the 48 hours before a PSA test.
  • Anal sex and prostate stimulation – if you are gay, bisexual or a man who has sex with men, being the receptive partner during anal sex might raise your PSA level. Having your prostate stimulated during sex might also raise your PSA level. It might be worth avoiding this for a week before a PSA test.
  • A DRE before a PSA test might raise your PSA level a small amount.
  • A prostate biopsy in the six weeks before a PSA test.
  • Other investigations or operations on your bladder or prostate, or a catheter. You may need to wait up to six weeks after these procedures before having a PSA test.

You should also let your GP know if you’re taking any prescription or over-the-counter medicines as some might affect your PSA level. For example, 5-alpha-reductase inhibitors to treat an enlarged prostate, such as finasteride (Proscar®) or dutasteride (Avodart®), can reduce your PSA level.

What will the test results tell me?

A PSA test alone can’t tell you whether you have prostate cancer, because other things can affect your PSA level. It’s normal to have a small amount of PSA in your blood, and the amount rises as you get older. The prostate gland gets bigger with age, and may produce more PSA.

What is a 'normal' PSA level and what is high?

The following figures are a very rough guide to ‘normal’ PSA levels, depending on your age.

A ‘normal’ PSA level is less than:

  • 3 ng/ml for men aged 50-59
  • 4 ng/ml for men aged 60-69
  • 5 ng/ml for men aged 70 and over.

This is just a guide – different GP surgeries might use slightly different figures. For example, in some places, a PSA level of less than 7 ng/ml might be seen as normal for men aged 70-75. Speak to your GP about what your results mean.

A high PSA level for your age can be a sign of prostate cancer. But it can also be a sign of other prostate problems such as an enlarged prostate or prostatitis.

If your test results are normal for your age, then you may not need any further tests. Or you may need another PSA test in the future.

A very high PSA level (for example in the hundreds or thousands) normally means that a man has prostate cancer. But if your PSA level is only slightly high for your age, then you will need other tests to help find out if there is a problem.

What happens next?

Your GP will look at several factors together to help you agree on the next step. These include:

  • the results of your PSA test
  • the results of a DRE
  • whether you are at higher risk of prostate cancer
  • any other health problems or things that may have affected the results
  • whether you’ve had a prostate biopsy in the past.

Your GP should discuss all this with you. They may also do another PSA test, especially if your PSA is only slightly raised.

Your GP will make an appointment for you to see a specialist at the hospital if they think you need more tests to work out whether you have a prostate problem or prostate cancer. You can also ask your GP to refer you to a specialist.

Regular PSA tests

After some men have had their first PSA test they might want to have tests every few years, particularly if they are more at risk of prostate cancer. This might be a good way to spot any changes in your PSA level which 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 call our Specialist Nurses.

There is some research that suggests that if you have a PSA test in your 40s, it might be possible to predict how likely you are to get fast-growing prostate cancer later in life. However, we don’t yet know exactly what PSA level would show this, or how often you should have more tests.

What are the pros and cons of the PSA test?

It’s important you think through the advantages and disadvantages of the PSA test. Having a PSA test is a personal decision – what might be an advantage for one man may not be for another.


  • A PSA test can help pick up prostate cancer before you have any symptoms.
  • A PSA test may help to pick up a fast-growing cancer at an early stage when treatment may stop the cancer spreading and causing problems.
  • Slow-growing prostate cancer might not need treatment. You might be able to have regular check-ups, including PSA tests, to keep an eye on your cancer. This can avoid or delay the side effects of treatment.
  • Having regular PSA tests could be helpful for men who are more at risk of prostate cancer. This can help spot any changes in your PSA level, which might be a sign of prostate cancer. But we need more research to show how often you might need a test.


  • You might have a raised PSA level, even if you don’t have prostate cancer. Around three quarters of men (76 per cent) with a raised PSA level don’t have prostate cancer.
  • If your PSA level is raised you may need more tests, including a biopsy. The biopsy has some risks, such as pain, infection and blood in the urine and semen. Up to 3 in 50 men (six per cent) may get a serious infection after a biopsy.
  • The PSA test can miss prostate cancer. 1 in 50 men (two per cent) with fast-growing prostate cancer have a normal PSA level. 
  • You might be diagnosed with a slow-growing prostate cancer which would never have caused you any problems or shortened your life.But being diagnosed with cancer could make you worry, and you might decide to have treatment that you didn’t need.
  • Treatments for prostate cancer have side effects which can affect your daily life. These include urinary and bowel problems, and problems getting and keeping an erection.

Should I have a PSA test?

Before you decide whether to have the test, try asking yourself these questions, or discuss them with your GP.

  • What is your risk of prostate cancer?
  • If the result of your PSA test was normal, would this reassure you?
  • If your PSA level was high, what would you do?
  • If you were diagnosed with slow-growing prostate cancer that might not cause you any problems in your lifetime, would you want to have treatment that may cause side effects that affect your daily life? 

It can be difficult to decide whether or not to have a PSA test. It might help to talk it over with your partner, family or friends. You could also talk to your GP or call our Specialist Nurses.

You might also find a decision aid helpful.  Decision aids help people make difficult decisions about their healthcare.

Use the NHS decision aid to help you decide whether to have a PSA test.

Why isn’t there a prostate cancer screening programme?

Screening programmes aim to spot the early signs of cancers in people who don’t have any symptoms. By finding cancer early, it could be treated in time to cure it. In the UK there are screening programmes for breast, cervical and bowel cancer.

There is currently no screening programme for prostate cancer. One reason for this is that the PSA test isn’t good enough at finding prostate cancer to be used as part of a screening programme.

It’s important that the benefits of a screening programme outweigh any disadvantages. But it’s not clear that screening 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 a large number of men would be diagnosed with a slow-growing cancer that wouldn’t have caused any symptoms or shortened their life. And a large number of these men would have treatment they didn’t need which could cause side effects. Other studies have found that screening doesn’t reduce the number of deaths from prostate cancer.

Although there's no screening programme, many men want a PSA test. So the Prostate Cancer Risk Management Programme was set up. This programme gives men over 50 who want a PSA test the right to have one on the NHS - as long as they have talked through the pros and cons with their GP.

Questions to ask your doctor or nurse

Questions to ask your GP or practice nurse

  • Am I at risk of prostate cancer?
  • What are the pros and cons of having a PSA test?
  • How long will I have to wait for the results?
  • If I have a PSA test and the result is normal, will I need to have regular tests in the future?
  • Will I need a digital rectal examination (DRE)?

Questions to ask your hospital specialist

  • Do I need a biopsy?
  • Will I have an MRI scan before having a biopsy?
  • What are the risks and side effects of a biopsy?
  • How soon will I get the results?
  • Will I need any other tests?
  • What support can I get?


Updated July 2014 | Due for Review: July 2016

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