Introduction to prostate tests
Introduction to prostate tests
Tests can find out whether you might have prostate cancer or another prostate problem, such as an enlarged prostate or prostatitis. You might hear these tests called a prostate check-up or prostate exam.
Why might I have prostate tests?
You may have tests if you’re at higher risk of getting prostate cancer. In the UK, about 1 in 8 men will get prostate cancer at some point in their lives. And you’re more likely to get prostate cancer if you’re aged 50 or over, you’re black, or your father or brother has had it. You may also be at higher risk if your mother or sister has had breast cancer.
Your GP might also suggest having tests if you have symptoms of a prostate problem. Prostate problems can cause urinary symptoms, such as needing to rush to the toilet or needing to go more often than normal.
Urinary symptoms are usually caused by problems that aren’t cancer, such as an enlarged prostate or a urine infection. And most men with early prostate cancer don’t have any symptoms.
Prostate cancer that has spread to other parts of the body can cause weight loss and pain in the back, hips or pelvis. These symptoms are often caused by other problems. But it’s a good idea to get any symptoms checked out by your GP. They will want to make sure you get the right diagnosis so you can get the right treatment, if you need it.
What tests are done at the GP surgery?
There is no single test to diagnose prostate cancer. There are a few tests that your GP can do to find out if you have a prostate problem. The main tests include:
- a urine test to rule out a urine infection
- a prostate specific antigen (PSA) blood test
- a digital rectal examination (DRE).
Before you have these tests, your GP should explain what they involve and talk you through the advantages and disadvantages of each test. They can help you understand more about prostate cancer and your own risk of getting it. It’s up to you whether you have the tests, so make sure you’ve got all the information you need, and give yourself time to think it through.
After you've had the tests, your GP will talk to you about all your test results and what they might mean. If they think you may have a prostate problem, they will make an appointment for you to see a specialist at the hospital. If they think you could have prostate cancer, you will usually see the specialist within two weeks.
Your GP may also give you a printed summary explaining what will happen when you go to hospital. We have a version for patients in England, as well as Scotland, that can be used as a reminder for yourself or those supporting you.
Download our referral summary for patients who live in England.
Download our referral summary for patients who live Scotland.
What tests are done at the hospital?
At the hospital you will see a specialist, who will usually be a doctor who specialises in the urinary and male reproductive system (urologist) or a specialist nurse. You may have another PSA test or DRE.
The specialist will look at your:
- PSA level
- DRE results
- risk of prostate cancer
- general health.
They might recommend another PSA test at your GP surgery in the future. Or they might recommend further tests, including:
- an MRI (magnetic resonance imaging) scan
- a prostate biopsy
- a CT (computerised tomography) scan
- a bone scan – with or without X-rays.
You might also have a urine flow test and an ultrasound scan of your bladder. These are usually done to check for an enlarged prostate.
If you have a very high PSA level (for example, in the hundreds or thousands), you may have prostate cancer that has spread outside the prostate. So you might not need a biopsy. Instead, you may have a scan to show if there is cancer and see how far it has spread.
In some hospitals you might have a special type of MRI scan, called a multi-parametric MRI (mpMRI) scan, before having a biopsy. This can help your doctor see if there is any cancer inside your prostate, and how quickly any cancer is likely to grow. In other hospitals you may have a biopsy first.
If you’re worried about these tests or would like more information, speak to your doctor or nurse. Or you can speak to our Specialist Nurses.
References
Updated June 2022 | Due for Review June 2025
- Advising well men about the PSA test for prostate cancer: information for GPs [Internet]. GOV.UK. [cited 2022 Jan 5]. Available from: https://www.gov.uk/government/publications/prostate-specific-antigen-testing-explanation-and-implementation/advising-well-men-about-the-psa-test-for-prostate-cancer-information-for-gps
- Barber L, Gerke T, Markt SC, Peisch SF, Wilson KM, Ahearn T, et al. Family History of Breast or Prostate Cancer and Prostate Cancer Risk. Clin Cancer Res. 2018 Dec 1;24(23):5910–7.
- Hemminki K, Chen B. Familial association of prostate cancer with other cancers in the Swedish Family-Cancer Database. The Prostate. 2005 Oct 1;65(2):188–94.
- 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.
- 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 [Internet]. 2015 Dec [cited 2015 Nov 5];13(1). Available from: http://www.biomedcentral.com/1741-7015/13/171
- National Institute for Clinical Excellence. Suspected cancer: recognition and referral [Internet]. 2021. Available from: https://www.nice.org.uk/guidance/ng12
- National Institute for Health and Care Excellence. Lower urinary tract symptoms in men: management. 2015;26.
- National Institute for Health and Care Excellence. Prostate cancer: diagnosis and management. 2021.
- Office for Health Improvement and Disparities. Prostate specific antigen testing: advice for well men aged 50 and over [Internet]. GOV.UK; 2022 [cited 2022 Jan 27]. Available from: https://www.gov.uk/government/publications/prostate-specific-antigen-testing-description-in-brief
- Prostate cancer - Symptoms, diagnosis and treatment | BMJ Best Practice [Internet]. [cited 2022 Feb 4]. Available from: https://bestpractice.bmj.com/topics/en-gb/254