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PSA test: what it shows and what the NHS says

Guide Published

A PSA test measures prostate-specific antigen in the blood. The NHS says it is not a routine screening test, and results can be wrong in both directions.

Key points

  • A PSA test is a blood test that measures prostate-specific antigen, and a high level may be a sign of a prostate condition.
  • The NHS does not offer routine PSA screening, though testing is offered to some people, including men with a faulty BRCA2 gene and those with symptoms that suggest prostate cancer.
  • Men aged 50 or over without symptoms can ask their GP about a PSA test, after discussing the benefits and risks.
  • PSA results can be falsely reassuring or falsely alarming, and the test can find slow-growing cancers that might never have caused harm.

What is a PSA test?

A PSA test is a blood test that measures the amount of prostate-specific antigen. Prostate Cancer UK says a raised PSA may suggest a prostate problem, but not necessarily cancer.

A raised PSA can have several causes, so it is not a diagnosis on its own.

Is PSA testing part of NHS screening?

No. The NHS says routine PSA testing is not currently offered. The exception it describes is for men whose genetic tests have shown a faulty version of a gene called BRCA2.

A PSA test may also be recommended when someone has symptoms that could point to prostate cancer.

Can I ask my GP for a PSA test?

Outside the groups above, the NHS describes an informed-choice route in which a person can ask a GP about PSA testing. Men aged 50 or over can ask their GP about PSA testing even without symptoms.

The aim is to give clear information on the advantages and disadvantages of the test first. Asking a GP is the route to start that conversation.

What are the benefits of a PSA test?

A GOV.UK programme page, now withdrawn, said a large European trial showed PSA testing can reduce the risk of death from prostate cancer.

What are the limits and risks?

The NHS says PSA tests are unreliable. A result can suggest cancer when there is none, which is called a false positive. A normal result does not rule cancer out either: the NHS says around 1 in 7 men with a normal PSA may have prostate cancer.

The test can also find cancers that are unlikely to cause harm, known as overdiagnosis. Overtreatment of such cancers is a recognised concern. This is why the NHS presents the decision as an informed choice.

Anyone worried about symptoms can contact a GP; NHS 111 can advise if the surgery is closed, and 999 is for emergencies.

More guides and news

Educational content. This article summarises public guidance and announcements in plain English for education. It is not medical advice and it cannot say what is right for you: speak to a clinician about your own health, call NHS 111 if you are unsure what to do and 999 in an emergency.