This booklet is for men who are thinking about having a PSA test. It explains the advantages and disadvantages of the test, what the results might mean, and what will happen next.
Last updated: November 2016 To be reviewed: November 2018
Albertsen PC, Hanley JA, Fine J. 20-year outcomes following conservative management of clinically localized prostate cancer. Jama. 2005;293(17):2095–2101.
Allott EH, Masko EM, Freedland SJ. Obesity and Prostate Cancer: Weighing the Evidence. Eur Urol. 2013 May;63(5):800–9
Amin Al Olama A, Kote-Jarai Z, Schumacher FR, Wiklund F, Berndt SI, Benlloch S, et al. A meta-analysis of genome-wide association studies to identify prostate cancer susceptibility loci associated with aggressive and non-aggressive disease. Hum Mol Genet. 2013 Jan 15;22(2):408–15
Bancroft EK, Page EC, Castro E, Lilja H, Vickers A, Sjoberg D, et al. Targeted Prostate Cancer Screening in BRCA1 and BRCA2 Mutation Carriers: Results from the Initial Screening Round of the IMPACT Study. Eur Urol. 2014 Sep;66(3):489
Breast Cancer Linkage Consortium. Cancer risks in BRCA2 mutation carriers. J Natl Cancer Inst. 1999;91(15):1310–1316
Cancer Research UK. Cancer incidence for common cancers (2015) [Internet]. [cited 2016 May 19]. Available from: http://www.cancerresearchuk.org/health-professional/cancer-statistics/incidence/common-cancers-compared
Cancer Research UK. Prostate cancer incidence statistics: Lifetime risk of prostate cancer (2012) [Internet]. [cited 2016 Jul 6]. Available from: http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/prostate-cancer/incidence#heading-Four
Cao Y, Ma J. Body Mass Index, Prostate Cancer-Specific Mortality, and Biochemical Recurrence: a Systematic Review and Meta-analysis. Cancer Prev Res (Phila Pa). 2011 Jan 13;4(4):486–501
Carter HB, Ferrucci L, Kettermann A, Landis P, Wright EJ, Epstein JI, et al. Detection of Life-Threatening Prostate Cancer With Prostate-Specific Antigen Velocity During a Window of Curability. JNCI J Natl Cancer Inst. 2006 Nov 1;98(21):1521–7
Castro E, Eeles R. The role of BRCA1 and BRCA2 in prostate cancer. Asian J Androl. 2012;14(3):409–414
Clinical Effectiveness Group - British Association of Sexual Health and HIV. United Kingdom National guideline for the management of prostatitis (2008). 2008
Collin SM, Metcalfe C, Donovan J, Lane JA, Davis M, Neal D, et al. Associations of lower urinary tract symptoms with prostate-specific antigen levels, and screen-detected localized and advanced prostate cancer: a case-control study nested within the UK population-based ProtecT (Prostate testing for cancer and Treatment) study. BJU Int. 2008 Jun 6;102(0):1400–6.
Crawford ED. Understanding the Epidemiology, Natural History, and Key Pathways Involved in Prostate Cancer. Urology. 2009 May;73(5):S4–10.
D’Amico AV, Renshaw AA, Sussman B, Chen M-H. Pretreatment PSA velocity and risk of death from prostate cancer following external beam radiation therapy. Jama. 2005;294(4):440–447.
D’Amico AV, Chen M-H, Roehl KA, Catalona WJ. Preoperative PSA velocity and the risk of death from prostate cancer after radical prostatectomy. N Engl J Med. 2004;351(2):125–135.
Dianat SS, Margreiter M, Eckersberger E, Finkelstein J, Kuehas F, Herwig R, et al. Gene polymorphisms and prostate cancer: the evidence. BJU Int. 2009;104(11):1560–1572
Discacciati A, Orsini N, Wolk A. Body mass index and incidence of localized and advanced prostate cancer--a dose-response meta-analysis of prospective studies. Ann Oncol. 2012 Jan 6;23(7):1665–71
Gacci M, Eardley I, Giuliano F, Hatzichristou D, Kaplan SA, Maggi M, et al. Critical Analysis of the Relationship Between Sexual Dysfunctions and Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia. Eur Urol. 2011 Oct;60(4):809–25.
Haffner J, Lemaitre L, Puech P, Haber G-P, Leroy X, Jones JS, et al. Role of magnetic resonance imaging before initial biopsy: comparison of magnetic resonance imaging-targeted and systematic biopsy for significant prostate cancer detection. BJU Int. 2011 Oct 1;108(8b):E171–8.
Häggström C, Stocks T, Ulmert D, Bjørge T, Ulmer H, Hallmans G, et al. Prospective study on metabolic factors and risk of prostate cancer: Metabolic Factors and Prostate Cancer. Cancer. 2012 Dec 15;118(24):6199–206
Ho T, Gerber L, Aronson WJ, Terris MK, Presti JC, Kane CJ, et al. Obesity, Prostate-Specific Antigen Nadir, and Biochemical Recurrence After Radical Prostatectomy: Biology or Technique? Results from the SEARCH Database. Eur Urol. 2012 Nov;62(5):910–6.
Ilic D, Neuberger MM, Djulbegovic M, Dahm P. Screening for prostate cancer. Cochrane Database Syst Rev. 2013;(1).
Jones AL, Chinegwundoh F. Update on prostate cancer in black men within the UK. Ecancermedicalscience. 2014;8:455.
Kheirandish P, Chinegwundoh F. Ethnic differences in prostate cancer. Br J Cancer. 2011 Aug 9;105(4):481–5
Kiciński M, Vangronsveld J, Nawrot TS. An Epidemiological Reappraisal of the Familial Aggregation of Prostate Cancer: A Meta-Analysis. Little J, editor. PLoS ONE. 2011 Oct 31;6(10):e27130.
Kirby M, Chapple C, Jackson G, Eardley I, Edwards D, Hackett G, et al. Erectile dysfunction and lower urinary tract symptoms: a consensus on the importance of co-diagnosis. Int J Clin Pract. 2013 Jul;67(7):606–18.
Kirkham APS, Emberton M, Allen C. How good is MRI at detecting and characterising cancer within the prostate? Eur Urol. 2006 Dec;50(6):1163–1174; discussion 1175
Klein LT, Lowe FC. The effects of prostatic manipulation on prostate-specific antigen levels. Urol Clin North Am. 1997 May;24(2):293–7.
Kramer BS, Hagerty KL, Justman S, Somerfield MR, Albertsen PC, Blot WJ, et al. Use of 5- -Reductase Inhibitors for Prostate Cancer Chemoprevention: American Society of Clinical Oncology/American Urological Association 2008 Clinical Practice Guideline. J Clin Oncol. 2009 Mar 20;27(9):1502–16
Lloyd T, Hounsome L, Mehay A, Mee S, Verne J, Cooper A. Lifetime risk of being diagnosed with, or dying from, prostate cancer by major ethnic group in England 2008–2010. BMC Med. 2015 Dec;13(1).
Loeb S, Carter HB, Catalona WJ, Moul JW, Schroder FH. Baseline Prostate-Specific Antigen Testing at a Young Age. Eur Urol. 2012 Jan;61(1):1–7.
Loeb S, Carter HB, Schaeffer EM, Kettermann A, Ferrucci L, Metter EJ. Distribution of PSA Velocity by Total PSA Levels: Data From the Baltimore Longitudinal Study of Aging. Urology. 2011 Jan;77(1):143–7.
Loeb S, Vellekoop A, Ahmed HU, Catto J, Emberton M, Nam R, et al. Systematic review of complications of prostate biopsy. Eur Urol. 2013 Dec;64(6):876–92.
McNaughton-Collins M, Joyce G, Wise M, Pontari M. Prostatitis. In: Urologic Diseases in America US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, US: Government Publishing Office; 2007.
McPherson K, Steel CM, Dixon JM. Breast cancer - epidemiology, risk factors, and genetics. ABC Breast Dis. 2000;572:24.
Mottet N, Bellmunt J, Briers E, Bolla M, Cornford P, De Santis M, et al. Guidelines on prostate cancer. European Association of Urology; 2016
Nakagawa H. Prostate cancer genomics by high-throughput technologies: genome-wide association study and sequencing analysis. Endocr Relat Cancer. 2013 Jun 24;20(4):R171–81.
National Institute for Health and Care Excellence. Suspected cancer: recognition and referral. NICE Guideline 12. 2015.
National Institute for Health and Care Excellence. Prostate Cancer: diagnosis and treatment. Full guideline 175. 2014.
National Institute for Health and Care Excellence. Lower urinary tract symptoms in men: assessment and management. NICE Clinical Guideline 97. (modified June 2015); 2010.
NHS Choices. GP complaints - Patient choice - NHS Choices [Internet]. 2013 [cited 2014 Apr 3]. Available from: http://www.nhs.uk/choiceinthenhs/yourchoices/gpchoice/pages/gpcomplaints.aspx
NHS National Services Scotland. Compliments, concerns or complaints [Internet]. 2014. Available from: http://www.nhsnss.org/pages/contact/feedback_and_complaints.php
Ørsted DD, Nordestgaard BG, Jensen GB, Schnohr P, Bojesen SE. Prostate-Specific Antigen and Long-Term Prediction of Prostate Cancer Incidence and Mortality in the General Population. Eur Urol. 2012 May;61(5):865–74.
Perlman G, Drescher J. Introduction: What Gay Men (and Those Near and Dear to Them) Need to Know About Prostate Cancer. J Gay Lesbian Psychother. 2005;9(1–2):1–7
Popiolek M, Rider JR, Andrén O, Andersson S-O, Holmberg L, Adami H-O, et al. Natural History of Early, Localized Prostate Cancer: A Final Report from Three Decades of Follow-up. Eur Urol. 2013;63(3):428–35.
Press Office D for H. Make a complaint against the health service | nidirect [Internet]. 2008 [cited 2014 Apr 3]. Available from: http://www.nidirect.gov.uk/make-a-complaint-against-the-health-service
Preston MA, Batista JL, Wilson KM, Carlsson SV, Gerke T, Sjoberg DD, et al. Baseline Prostate-Specific Antigen Levels in Midlife Predict Lethal Prostate Cancer. J Clin Oncol [Internet]. 2016 Jun 13 [cited 2016 Jun 27]; Available from: http://jco.ascopubs.org/cgi/doi/10.1200/JCO.2016.66.7527
Price CP, Allard J, Davies G, Dawnay A, Duffy MJ, France M, et al. Pre-and post-analytical factors that may influence use of serum prostate specific antigen and its isoforms in a screening programme for prostate cancer. Ann Clin Biochem. 2001;38(3):188–216
Public Health England. Prostate cancer risk management programme (PCRMP): benefits and risks of PSA testing [Internet]. GOV.UK; 2016. Available from: https://www.gov.uk/government/publications/prostate-cancer-risk-management-programme-psa-test-benefits-and-risks/prostate-cancer-risk-management-programme-pcrmp-benefits-and-risks-of-psa-testing
Rebbeck TR, Devesa SS, Chang B-L, Bunker CH, Cheng I, Cooney K, et al. Global Patterns of Prostate Cancer Incidence, Aggressiveness, and Mortality in Men of African Descent. Prostate Cancer. 2013;2013:1–12
Rees J, Abrahams M, Doble A, Cooper A, the Prostatitis Expert Reference Group (PERG). Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline. BJU Int. 2015 Oct;116(4):509–25
Roehrborn CG. BPH progression: concept and key learning from MTOPS, ALTESS, COMBAT, and ALF-ONE. BJU Int. 2008;101 Suppl 3:17–21
Rosario DJ, Lane JA, Metcalfe C, Donovan JL, Doble A, Goodwin L, et al. Short term outcomes of prostate biopsy in men tested for cancer by prostate specific antigen: prospective evaluation within ProtecT study. BMJ. 2012;344:d7894
Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E, et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol. 2003 Dec;44(6):637–49
Santillo V., Lowe C. Prostate cancer and the gay male. In: A gay man’s guide to prostate cancer. Binghamton, NY: The Haworth Medical Press; 2005. p. 29–41.
Schröder FH, Hugosson J, Roobol MJ, Tammela TLJ, Zappa M, Nelen V, et al. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. The Lancet. 2014 Dec;384(9959):2027–35
Schroeder FH, Hugosson J, Roobol MJ, Tammela TLJ, Ciatto S, Nelen V, et al. Screening and Prostate-Cancer Mortality in a Randomized European Study. N Engl J Med. 2009;360(13):1320–8
Shoskes DA. The Challenge of Erectile Dysfunction in the Man with Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Curr Urol Rep. 2012 May 13;13(4):263–7
Tarhan F, Orçun A, Küçükercan I, Camursoy N, Kuyumcuoğlu U. Effect of prostatic massage on serum complexed prostate-specific antigen levels. Urology. 2005 Dec;66(6):1234–8
Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level ≤4.0 ng per milliliter. N Engl J Med. 2004;350(22):2239–46
Vickers AJ, Ulmert D, Sjoberg DD, Bennette CJ, Bjork T, Gerdtsson A, et al. Strategy for detection of prostate cancer based on relation between prostate specific antigen at age 40-55 and long term risk of metastasis: case-control study. BMJ. 2013 Apr 16;346(apr15 5):f2023–f2023
World Cancer Research Fund International. Continuous Update Project report: Diet, Nutrition, Physical Activity and Prostate Cancer [Internet]. 2014.
Wespes E, Eardley I, Giuliano F, Hatzichristou D, Hatzimouratidis K, Moncada I, et al. Male Sexual Dysfunction. 2013