A guide for men considering a PSA Test

Any man over 50 (45 where there is a family history of prostate cancer) is entitled to an annual PSA Test

1. The PSA test is a simple blood test which is used to help detect prostate cancer. In its early stages, prostate cancer generally produces no symptoms, so it's important to diagnose the disease before any symptoms arise and while it is still potentially curable. Results of a major European trial suggest that treating prostate cancer may significantly prolong a man's life.
   
   
2. A high level of PSA (usually 10 ng/ml and above) is likely to be an indicator of prostate cancer and should therefore prompt further investigation.
   
   
3. A moderately raised PSA level (usually 4ng/ml and above, but this depends on age), means that other factors, including digital rectal examination, ethnicity, family history, and free-to-total PSA ratio, should be considered in determining whether to send a man for further tests, such as an MRI scan or biopsy.
   
   
4. However, in three-quarters of such cases, further tests do not detect cancer. This is because there are other reasons for a moderately elevated PSA, eg enlarged prostate, urinary infection - and these may need treatment.
   
   
5. Prostate cancer is not always aggressive or life-threatening. Even if further tests do reveal early-stage prostate cancer, a specialist may not be able to tell whether the condition is life-threatening or harmless. This may make treatment choices difficult for both patient and clinician.
   
   
6. A low level of PSA (usually below 4ng/ml, but this depends on age) does not guarantee the absence of prostate cancer. This is because localised prostate cancer does not always produce a raised level of PSA.
   
   
7. All these factors have led to the current controversy over the value of the PSA test. However, the uncertainties may be reduced by men having a regular test, ideally on an annual basis. Regular monitoring of PSA levels can highlight any significant or gradual increase, so that even when the PSA is within the 'normal' range, a man may be alerted to the need for further investigation.

For more information click here for :

"PSA testing for prostate cancer: information for well men considering a PSA test"

produced by Public Health England and available online at

https://www.gov.uk/government/publications