Prostate cancer - PSA screening 

Screening for prostate cancer 

There is currently no screening programme for prostate cancer in the UK because it has not been proven that the benefits would outweigh the risks.

PSA screening

Routinely screening all men to check their prostate-specific antigen (PSA) levels is a controversial subject in the international medical community.

In some countries, all men aged over 50 are recommended to have an annual PSA test. However, this is not the case in the UK.

There are several reasons for this:

  • PSA tests are unreliable and often suggest the presence of prostate cancer when no cancer exists (a false-positive result). This means many men often have invasive and sometimes painful biopsies for no reason.
  • Treating prostate cancer in its early stages can be beneficial, but side effects of the various treatments are potentially so serious that men may choose to delay treatment until it is absolutely necessary.
  • Although screening has been shown to reduce a man’s chance of dying from prostate cancer, it would mean many men getting treated unnecessarily.

One European study has shown deaths from prostate cancer could be reduced by 20% if there was a screening programme, but only one additional life would be saved for every 48 men treated.

As there are many reasons why PSA levels may be high at any one time, researchers are trying to make the PSA test, or a variation of it, more accurate. This includes looking at how PSA levels change over time, and comparing the PSA level to prostate size.

Instead of a national screening programme, there is an informed choice programme on prostate cancer risk management. It aims to give men good information on the pros and cons of a PSA test.

If you are aged over 50 and decide to have your PSA levels tested, your GP will be able to arrange for it to be carried out for free on the NHS.

Should I have a PSA test?

Because the results of the PSA test are not as reliable as doctors would like, other tests and investigations are needed to diagnose prostate cancer. A PSA test cannot identify prostate cancer on its own, and changes in PSA levels alone are not a good reason to start treatment.

If you are going to have a PSA test, it is important you first discuss with your GP whether it is right for you, so you understand what the results might mean.

The Prostate Cancer Risk Management Programme gives you information on the risks and benefits of the PSA test to help you decide whether or not to have it. 

Want to know more?


Page last reviewed: 06/11/2012

Next review due: 06/11/2014

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The 4 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Trevor47 said on 21 July 2014

You might like to read this article as it gives global view on PSA testing

http://www.canceractive.com/cancer-active-page-link.aspx?n=171

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tfergus1 said on 25 March 2014

Some of this information is confusing and appears to be contradictory: "One European study has shown deaths from prostate cancer could be reduced by 20% if there was a screening programme, but only one additional life would be saved for every 48 men treated." Lets examine this statement... deaths would be reduced by 20%... then it says only one life saved for every 48 treated which is about 2%. So which is it 20% or 2 %?

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chimsha said on 29 March 2012

This is a typical example of very dubious logic. My father died many years ago of metastasis from prostrate cancer, if he had been screened in time, he might have survived, This was in Spain 1976. Now when I have a blood test, usually every year, I also have the PSA test. This is considered normal for males over 50. People are told that a high value does not mean cancer. I find the reasoning expressed above totally impossible to understand. If your levels are high, you would be sent for an examination by a urologist, who would then stick a finger up your backside and palpate your prostrate, unpleasant no doubt but hardly invasive. If your was large, you might then be sent for an ecograph, hardly invasive. It is a well known fact that when you start having symptoms of prostrate cancer, treatment options are worse! I am now in the U.K., visited my doctor and as I had to have a blood test for other matters, asked for a PSA screening at the same time & was treated to this dubious logic. Well, if I can't get it here (is it a question of money?), I'll just have to have it done in Spain.

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SandyTB said on 16 October 2009

Your article on PSA screening says: "Also many men who received an early diagnosis then reported that they wish they have never been told. This is because they had to live for many years with the anxiety that the diagnosis gave them, yet the actual condition itself caused no significant physical pain."

Please can you quote any evidence for this statement. In the 7+ years I have been involved with Ca P patients' groups, during which time I must have spoken to several hundred patients, I have only ever met 1 man who expressed any such regrets. Hardly "many".


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