Prostate cancer is the most common cancer in men in the UK. Many men want to understand their risk and whether they should have a PSA blood test — but are often unsure what the result actually means, or what they should do next.
This article is designed as a starting point.
I’ll explain:
- what the PSA test is (and what it isn’t)
- who should consider prostate cancer screening
- common risk factors and urinary symptoms
- why screening can still be appropriate even without symptoms
- and how to approach decisions calmly and proportionately
This is about understanding risk.
What Is the PSA Test?
PSA (prostate-specific antigen) is a protein produced by prostate tissue. A PSA blood test measures how much of this protein is circulating in your bloodstream.
PSA can rise for many reasons, including:
- benign prostate enlargement,
- prostate inflammation or infection,
- recent ejaculation,
- cycling or strenuous exercise,
- and prostate cancer.
Because PSA is not cancer-specific, it works best as part of a structured screening discussion, not as a standalone answer.
Prostate Cancer Screening: What Are We Actually Trying to Do?
Screening means checking for prostate cancer before symptoms develop.
In the UK, there is no national screening programme, because PSA testing has benefits and limitations. Instead, men are encouraged to make an informed choice.
The goal is:
- to identify clinically significant prostate cancer early (the type more likely to need treatment),
- while avoiding unnecessary scans, biopsies, and anxiety for men at low risk.
Risk Factors Worth Knowing
Your personal risk is influenced by:
- Age – risk rises after 50
- Family history – especially first-degree relatives
- Ethnicity – Black men have a higher lifetime risk
- Genetics – certain inherited variants increase risk
Having risk factors doesn’t mean you will develop prostate cancer — but it does mean screening discussions may be more relevant earlier.
Lower Urinary Tract Symptoms (LUTS) — and an Important Clarification
Common urinary symptoms include:
- slow or weak stream,
- needing to urinate more often (especially at night),
- urgency,
- difficulty starting or stopping.
These symptoms are very common and are usually caused by benign prostate enlargement.
Importantly, you do not need urinary symptoms to consider prostate cancer screening.
Early prostate cancer often causes no symptoms at all. Screening decisions are therefore based on risk factors and age, not symptoms alone.
How Accurate Is the PSA Test? (In Plain English)
PSA is helpful — but imperfect.
- False positives:
- Around 3 in 4 men with a raised PSA do not have prostate cancer.
- False negatives:
- Some men with prostate cancer have a PSA in the “normal” range.
This is why PSA is best thought of as a risk signal, not a diagnosis — and why follow-up decisions matter.
The 30-Second Prostate Cancer Risk Checker
A good place to start is the 30-second prostate cancer risk checker from Prostate Cancer UK.
👉 https://prostatecanceruk.org/risk-checker
It asks a few simple questions about:
- age,
- ethnicity,
- family history,
- urinary symptoms.
Many men use this before deciding whether to have a PSA test or book a consultation.
Already Had a PSA Test?
If you’ve already had a PSA — through your GP, privately, or as part of a health check — it’s very common to feel unsure about what the result actually means.
You don’t need to repeat the test straight away to get advice.
A consultation can help you:
- interpret your PSA in context,
- understand whether further tests are appropriate,
- and navigate the next steps calmly and sensibly.
Those next steps might include monitoring, additional blood tests, prostate MRI, or reassurance with a clear follow-up plan.
This Is the First Article in a Screening Series
This post is an introduction to a short series on prostate cancer screening.
Next, I’ll cover:
- What is considered a Normal PSA Result?
- Stockholm3 — when PSA is unclear and how risk is refined
- Proclarix — another biomarker-based test used in the PSA grey zone
- Prostate MRI screening — when it helps, when it doesn’t, and how it fits into modern pathways
Each article builds on this foundation.
Notice: This content is for general information only and is not a substitute for personalised medical advice from your GP or healthcare professional.