The problem with home urine tests for prostate cancer

Home urine tests have become an increasingly popular option for men concerned about prostate cancer, with products heavily marketed on social media and available to buy online.  

Here, we take a closer look at what the tests claim and offer guidance on what to do if you’re concerned. 

What is a home urine test for unseen blood? 

According to some manufacturers, it is a test for unseen blood to detect early warning sign of various conditions, including prostate cancer.

An individual test as such can cost £20 + £4.99 shipping, whereas a PSA test – the best first test for potential prostate cancer – is free from your GP. 

What’s the problem? 

The problem is that microscopic and invisible haematuria (blood in urine) is not a sign of prostate cancer. 

Microscopic haematuria is distinct from visible haematuria (visible blood in the urine). Visible haematuria is a recognised (but rare) sign of prostate cancer, as well as other conditions such as an enlarged prostate or a urinary tract infection. You should always visit your GP if you have visible blood in your urine. 

However, microscopic haematuria is not recognised by NHS clinical guidelines as a sign of prostate cancer, and as far as we are aware there is no evidence to support any claims that it indicates an increased risk of prostate cancer or is an ‘early warning sign’. There’s also no evidence testing for it may lead to earlier detection of prostate cancer.  

No evidence is provided by the manufacturer either.  

We also don’t know about the test’s sensitivity or specificity for diagnosing prostate cancer. A recent study by University College London (UCL) found 0 cases of prostate cancer in 1,245 patients presenting with microscopic haematuria. 

Essentially, we cannot properly advise people on these tests because they haven't been evaluated -  by anyone.  

Therefore, there is no evidence (that we are aware of) to support their use in the early detection of prostate cancer. From what we do know about prostate cancer and microscopic haematuria, the tests are unlikely to be of any benefit whatsoever and may cause unnecessary anxiety 

The marketing of this product highlights the “peace of mind” it provides to men who are worried about their health. 

All screening tests - even very good ones - carry a risk of false negatives, so cannot give complete "peace of mind". But to claim this when testing for microscopic haematuria is particularly misleading. Because, as indicated above, there is no evidence that this aids the understanding or early detection of prostate cancer.

While we don’t recommend home urine tests such as this one, other types of urine tests do have potential to help us diagnose prostate cancer. We’re currently funding research into a urine test that could detect whether a prostate cancer is aggressive or not, and help some men avoid a biopsy. 

What should I do? 

What we know is that most early prostate cancers do not have any symptoms. Men over 50 who are worried about prostate cancer do not need to have symptoms to access free PSA testing via the NHS. 

Any man worried about prostate cancer should speak to their GP in the first instance.  

Testing for invisible blood in your urine is an unnecessary step, with no evidence of benefit for the detection of prostate cancer. You can read more about tests and checks used to see if you have prostate cancer or another prostate problem here. 

If you’re concerned about prostate cancer, check your risk in just 30 seconds. 

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The NSC's stance on commercial health screening tests

The UK National Screening Committee (NSC) has recently updated its information on their blog about how commercial screening tests as such differ from NHS screening programmes. You can read more about this guidance on the link below to learn about the potential benefits and harms of all screening, as well as the possible issues to think about when considering a commercially offered health screening test. 

The issues highlighted include that:

• Commercial companies often only offer a test rather than an end-to-end screening pathway, meaning that with an abnormal finding, it is up to the individual to follow up.
• Private companies may offer screening that isn't evidence-based, with no reliable studies to confirm that it leads to improved health outcomes.
• Tests as such can cost several hundreds of pounds whilst providing no health benefits in isolation.

Nevertheless, the UK NSC cannot say with confidence that the same is true for all commercial screening tests.

The blog lists and expands on 7 important questions that you might want to consider before deciding to take a commercial screening test:

1. What would be the benefits of having the test?
2. Is the test already offered for free on the NHS?
3. Is the company properly regulated?
4. What do the fees cover?
5. Can the test do more harm than good?
6. What if the test picks something up?
7. What if there are no clear results?

How commercial screening tests differ from NHS screening programmes (UK NSC)