Should I get tested for Prostate Cancer? A Doctors guide to PSA testing.
Prostate cancer is the most commonly diagnosed cancer in men.
It affects every 1 in every 8 individuals and is especially prevalent in men over 65.
Prostate cancer testing - specifically PSA (prostate specific antigen) testing - has become increasingly accessible in the last few years.
What used to involve a slightly awkward prostate exam with a clinician can now be done with a simple blood test.
And in one sense, that’s great. Tests are much more accessible and reduce the fear of embarrassment some men may feel when thinking about getting tested. But on the other hand, tests like these can cause unnecessary anxiety and stress if not done under the guidance of a trained doctor.
Routine PSA testing is not offered or advertised by the NHS but men over the age of 50 are still able to ask their NHS GP for a test even if they do not have any symptoms of prostate cancer.
You may be thinking - Why? If PSA testing can tell me if I have cancer or not, then why shouldn’t I get one? And why does the NHS limit testing to men over 50 when this cancer can affect men much younger than that? Surely PSA tests should be offered to everyone? Should I pay to get tested privately if the NHS won’t see me?
My honest answer to all of these questions is this:
Yes. PSA testing is a very important and useful diagnostic tool. Studies have shown that screening using PSA tests reduced prostate cancer related deaths, however, the tests also lead to overdiagnosis (finding low-risk cancers that may never cause harm), overtreatment (treatment side effects for cancers that didn’t need urgent intervention), and unnecessary harm to patients.
As clinicians, we often see the downside of PSA tests done without the context of additional symptoms, family history or lifestyle factors. We see the phone calls that trigger anxiety — “We need to discuss your result” — we see patients coming in panicked and confused and we see the harm that can be caused by issues that never would have bothered patients to begin with.
If you are concerned about your health, the best thing you can do is talk to your GP. They will be able to give you the best advice on your individual health and circumstances. Rushing into getting tested can come at the cost of your time, money and mental health.
Why PSA testing is valuable (and what the evidence really says):
PSA is not a “yes/no cancer test.” It identifies your risk of certain cancers — and like anything that identifies risk; it’s most useful when interpreted properly. Once clinicians like myself have the results, we can direct patients to the right clinical pathway (the actions that are taken by healthcare providers after the result of a test is known), and give patients the right steps on what they can do next.
Modern clinical pathways pair PSA testing with:
risk assessment and calculators
multiparametric MRI scans (mpMRI)
and, where appropriate, additional biomarkers
This combination improves detection of clinically significant cancers while reducing unnecessary biopsies and treatment harms. That shift is reflected in contemporary professional and charity-led guidance and reviews. (Prostate Cancer UK)
Essentially: PSA testing can offer a modest reduction in prostate cancer related deaths when used in a structured, risk-adapted pathway — but the benefits must be balanced against the harms, which is why shared decision-making is essential. (PMC)
Why the UK still doesn’t have blanket national screening for everyone:
Many men ask: “If prostate cancer is common, why don’t we screen everyone like we do for bowel cancer?”
The UK National Screening Committee (UK NSC) has repeatedly judged that population-wide screening risks causing more harm than benefit overall — largely because PSA can detect slow-growing cancers that wouldn’t have caused problems, and treatment can carry major side effects. (nationalscreening.blog.gov.uk)
That said, this area is consistently reviewed and actively evolving. In late 2025, the UK NSC opened consultation on a draft recommendation for targeted screening in men with confirmed BRCA1/BRCA2 variants (reflecting higher risk of aggressive disease). (nationalscreening.blog.gov.uk)
But for now, the recommendations are clear: More targeted, risk-calculated strategies, and not one-size-fits-all testing.
Who should consider a PSA test — and when?
Average risk individuals: Medical guidance supports discussing PSA testing from around age 50, especially if the individual wants to make an informed choice after understanding pros/cons.
Higher risk individuals (consider earlier discussion/testing):
You may benefit from earlier assessment if you have:
strong family history (e.g., father/brother affected)
Black African or Black Caribbean ancestry
known BRCA1/BRCA2 (or relevant familial cancer history)
symptoms suggesting prostate disease (urinary changes, blood in urine/semen, persistent pelvic pain)
This “start earlier if higher risk” approach is echoed in major public-facing explainers and clinical guidance.
What’s the best way to prepare for a PSA test. (to reduce false alarms):
Small factors can nudge PSA up and cause avoidable worry. It’s best to make sure you prepare properly so you can get the most accurate reading and therefore the best care for you.
Before a PSA blood test, good practice is to:
avoid ejaculation for ~48 hours beforehand
avoid vigorous cycling/exercise that may irritate the prostate
postpone testing if you have symptoms of a urine infection (and treat first)
ensure the clinician knows about prostate enlargement symptoms or prostatitis history
And crucially: don’t act on a single abnormal result in isolation. The UK’s primary-care guidance is explicit about informed discussion and careful interpretation.
What happens if PSA is raised?
A raised PSA should usually trigger a structured next step — not panic and not an automatic biopsy.
Contemporary guidance emphasises:
confirm and contextualise (symptoms, family history, prior PSA trend, medications, recent infection)
consider repeat PSA (especially if borderline or if a confounder is likely)
use risk tools and proceed to mpMRI scan where appropriate
reserve biopsy for men with higher calculated risk and/or suspicious imaging
This “PSA → MRI-first → targeted biopsy when needed” approach is now a core theme in professional guidance.
How we minimise harm:
The worry many men have isn’t just cancer — it’s also the fear of consequences: biopsies, anxiety, overtreatment, incontinence, erectile dysfunction.
Modern, harm-reduction strategies include:
avoiding testing in men unlikely to benefit (for example, very limited life expectancy)
age- and risk-informed thresholds and intervals
MRI-led pathways to reduce unnecessary biopsies
“active surveillance” for low-risk disease rather than immediate radical treatment
This is why PSA should be framed as a decision and not as a default test.
“But what are people reading about PSA right now?”
Public interest is high at the moment, and more and more men are becoming conscious about their health.
Health consciousness is great. But it needs the right support in order to benefit people properly.
The CCC approach: PSA testing with clarity, not anxiety:
At CCC, we don’t treat PSA as “just a blood test.”
We treat it as a marker for clinical decision — this means we consider:
a proper history (symptoms, urinary changes, sexual health, family history)
discussion of pros/cons and your preferences
clear explanation of what results can and can’t tell us
a safe plan for what happens next (including when to repeat, when to reassure, and when to refer)
PSA testing is most valuable when it reduces uncertainty and points towards a clear path of care.
If you’re considering a PSA test — or you’ve had one done and feel unsure what it means — book a Men’s Health / Prostate Health consultation with CCC.
We’ll help you understand:
whether PSA testing is right for you
how to do it properly
what your result means in context
and what the sensible next step is (if any)
Our goal is for you to feel reassured and confident. Putting information and control into your hands. Taking targeted action, if and when necessary.
📍Book a consultation at CCC and discuss PSA testing today.
🌐www.completeclinicalcare.co.uk
