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 like the IcleTest 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 a manufacturer of one such test (the IcleTest), it is a “Home Urine Test for Unseen Blood. It's Your Early Warning System”. 

Their website goes on to advise people that “blood in your pee is often invisible to the naked eye and can be an early sign of several conditions,” including prostate cancer. 

An individual test from this website costs £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 is 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. 

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