What's a raised PSA level?
The amount of PSA in your blood is measured in nanograms of PSA per millilitre of blood (ng/ml).
If you're aged 50 to 69, raised PSA is 3ng/ml or higher.
A raised PSA level in your blood may be a sign of prostate cancer, but it can also be a sign of another condition that's not cancer, such as:
How accurate is the PSA test?
About 3 in 4 men with a raised PSA level will not have cancer. The PSA test can also miss about 15% of cancers.
Pros and cons of the PSA test
- it may reassure you if the test result is normal
- it can find early signs of cancer, meaning you can get treated early
- PSA testing may reduce your risk of dying if you do have cancer
- it can miss cancer and provide false reassurance
- it may lead to unnecessary worry and medical tests when there's no cancer
- it cannot tell the difference between slow-growing and fast-growing cancers
- it may make you worry by finding a slow-growing cancer that may never cause any problems
Before having the test
If you're having a PSA test, you should not have:
- ejaculated in the past 48 hours
- exercised heavily in the past 48 hours
- a urinary infection
- had a prostate biopsy in the past 6 weeks
Each of these may give an inaccurate PSA reading.
Digital rectal examination (DRE)
Your GP may also perform a digital rectal examination (DRE) to feel for any changes to your prostate gland.
A DRE is done by inserting a gloved, lubricated finger into your back passage.
A DRE on its own is not enough to detect cancer.
If you have a raised PSA level, you may need other tests, such as a biopsy.
This involves taking small samples of your prostate and checking them for cancer.
Biopsies miss 1 in 5 prostate cancers and can sometimes cause complications. The most common are bleeding and infections.
If you have prostate cancer
If you have prostate cancer, your specialist will discuss your options with you.
Possible treatments include:
- watchful waiting
- active surveillance
- radical prostatectomy (surgery)
Side effects of some treatments can include problems with erections, loss of fertility and incontinence.
You should talk to your cancer specialist about the benefits and risks of any treatment before you begin.
Read more about treating prostate cancer.