PSA testing explained: what it measures, why it is a nuanced screening decision rather than a routine test, who might consider it, and what a raised result actually means.
PSA (prostate-specific antigen) is a protein produced by the prostate gland. A PSA blood test measures the amount circulating in your blood and is most commonly used as part of the conversation around prostate health in men over 50.
What does a PSA test measure?
PSA levels can rise for several reasons, not just prostate cancer. Common causes of a raised PSA include an enlarged prostate (benign prostatic hyperplasia, very common with age), prostatitis (inflammation or infection of the prostate), recent ejaculation, vigorous exercise (particularly cycling), and, less commonly, prostate cancer. This is exactly why PSA is described as a screening marker rather than a diagnostic test.
Why PSA testing is a nuanced decision
Unlike many blood tests, PSA screening isn’t universally recommended by UK guidelines for men without symptoms, because it carries real limitations:
- False positives are common: a raised PSA far more often reflects a benign cause than cancer.
- False negatives can occur: some prostate cancers don’t raise PSA significantly, especially in early stages.
- Overdiagnosis is a recognised concern: some prostate cancers detected via PSA screening would never have caused symptoms or harm in a man’s lifetime, yet the diagnosis itself, and any subsequent investigation or treatment, carries its own risks and anxieties.
This is why the NHS doesn’t currently offer a national PSA screening programme, but does allow men over 50 (or younger with a family history or other risk factors) to request a PSA test after discussing the pros and cons with their GP; a model sometimes called “informed choice”.
Who might consider testing?
- Men over 50, as part of an informed discussion about the benefits and limitations.
- Men with a family history of prostate cancer, who may be advised to consider testing earlier.
- Men of Black African or Black Caribbean descent, who have a higher lifetime risk of prostate cancer.
- Men experiencing urinary symptoms (though these are more commonly caused by benign prostate enlargement than cancer).
What happens if my PSA is raised?
A raised PSA doesn’t mean you have prostate cancer; it means further assessment is warranted. Your GP will consider your result alongside your age, symptoms and risk factors, and may arrange further investigation such as a specialist referral, an MRI scan, or a repeat test. It’s important to discuss any raised result promptly with your GP rather than self-interpreting the number.
Preparing for a PSA test
Because ejaculation, vigorous exercise, and some other factors can temporarily raise PSA, it’s often recommended to avoid ejaculation and strenuous exercise (especially cycling) for 48 hours before testing, to get the most representative result.
Getting tested
PSA is included in our Men’s Health Screen and cancer screening panels. We’d encourage you to consider discussing the decision to test with your GP first, if you’re asymptomatic, so you’re fully informed about what a result would mean.
Not sure which test is right for you? Use our free Test Finder for a personalised recommendation in under a minute.
Frequently asked questions
Does a raised PSA mean I have prostate cancer?
No; a raised PSA is far more commonly caused by benign conditions like an enlarged prostate or prostatitis. Further assessment by your GP is needed to understand the cause.
Why isn’t PSA testing offered to everyone routinely?
PSA screening has recognised limitations, including false positives and the risk of detecting cancers that would never have caused harm, so UK guidance favours informed individual choice rather than routine screening.
Should I speak to my GP before testing?
It’s a good idea, if you have no symptoms, so you understand what a result would and wouldn’t tell you before you decide to test.
Can exercise affect my result?
Yes; vigorous exercise, cycling, and recent ejaculation can temporarily raise PSA, so it’s often recommended to avoid these for 48 hours before testing.
How quickly will I get my results?
Most results are available within 1–2 working days and are reviewed by a GMC-registered doctor before you receive them.
Important note
This article is for general education only and is not medical advice or a diagnosis. PSA testing has genuine limitations and should be discussed with your GP before and after testing, regarding what an abnormal result means and what happens next. Trupoint Health blood tests are analysed by a UKAS-accredited laboratory and reviewed by a GMC-registered doctor.
Medically reviewed by: ____________ (GMC-registered), pending review.
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