What tests are done by my GP?
PSA test
The standard PSA test is a blood test that measures the total amount of PSA in your bloodstream. PSA is a protein produced by some of the cells in the prostate. A raised PSA level may show that there is a problem with the prostate. It cannot diagnose prostate cancer but the results of the PSA test together with other factors such as other test results, your family history and your ethnicity can help assess your risk.
The PSA test can be carried out by your GP or at the hospital. Your GP should give you information about the advantages and disadvantages of having the test and discuss any questions you have before you decide whether to have the test.
If you decide to have the PSA test, you may be asked to have a urine test first to check that you do not have a urine infection. Urine infections can affect your PSA result.
It can take up to two weeks to get the PSA test results. If the PSA result is abnormally high for your age, your doctor will either repeat the test, or arrange for you to have further tests.
The PSA result alone cannot tell you whether or not you have prostate cancer and a ‘normal’ PSA does not completely rule out prostate cancer. If you would like more detailed information about the PSA test, call our confidential Helpline on 0800 074 8383, or read our booklet PSA and beyond: A guide for men concerned about prostate cancer.
What can affect my PSA level?
All men have some PSA in their blood, and the PSA level can be affected by:
Age
PSA naturally rises with age because the prostate usually gets bigger with age. The accepted normal PSA test result is:
- Up to 3 ng/ml for men in their 50’s
- Up to 4 ng/ml for men in their 60’s and
- Up to 5 ng/ml for men in their 70’s and over.
These are just rough guides. PSA levels will vary slightly between laboratories, as they may use different testing methods. There is no upper limit to the PSA test result and some men may receive results in the hundreds and thousands. This is uncommon but is likely to indicate the presence of prostate cancer.
A urine infection
A urine infection can cause the PSA to rise temporarily so you may have a simple urine test to rule this out. If there are signs of an infection the sample will be sent to the laboratory to check if there are any bacteria present. If there is an infection, you will be given a course of antibiotics. A further urine sample is usually taken one to two days after completing the course of antibiotics to make sure that the infection has been treated.
The PSA test should be repeated six weeks after the infection has been treated.
BPH (benign prostatic hyperplasia)
BPH is a common condition that mainly affects many men over the age of 50. It is a non-cancerous enlargement of the prostate. The increase in size may cause the prostate gland to produce more PSA. Read our booklet Enlarged prostate: A guide for men concerned about benign prostatic hyperplasia (BPH) for more information.
Prostatitis
This is an inflammation or infection of the prostate gland. The inflammation allows more PSA to move from the prostate into the blood and causes the PSA level to rise. Read our booklet Prostatitis: A guide to infection or inflammation of the prostate for more information.
Prostate cancer
Prostate cancer may cause the PSA level in the blood to rise. However, some men with some rare types of prostate cancer or early prostate cancer may not have a raised PSA.
Vigorous exercise
It is not clear whether exercise such as cycling affects the PSA level. You may be advised to avoid vigorous exercise in the 48 hours before a PSA test.
Ejaculation
Ejaculation in the 48 hours before a PSA test may affect the results, especially in younger men 2. If you are going to have a PSA test, you may be advised to avoid sexual activity during this time.
Prostate biopsy
If you have had a biopsy in the last six weeks before a PSA test, this can affect the PSA result. 3
Catheter, cystoscopy and other procedures
Your PSA level may be affected if:
- You have a urethral catheter. This is a tube inserted into your bladder through the penis to drain urine.
- You have had a test called a cystoscopy.
This is an investigation where a long tube with a camera is passed through the penis to look into the bladder.
Other procedures that affect your prostate, such as a transurethral resection of the prostate (TURP) may have a similar effect. Your specialist may suggest waiting for up to six weeks after these procedures before taking a PSA test.
Medication
Some drugs can lower the PSA level in the blood stream. If you are taking medication for BPH, statins for cholesterol control or non-steroidal anti-inflammatory drugs (such as aspirin) discuss your PSA test results with your doctor or nurse.
References used in the production of this page.
2 Watson E et al. The PSA test and prostate cancer: information for primary care. NHS Cancer Screening Programmes, Sheffield; 2002.
3 Watson E et al. The PSA test and prostate cancer: information for primary care. NHS Cancer Screening Programmes, Sheffield; 2002.