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PSA test for prostate cancer

Prostate cancer leaflet

There is a test, called the PSA test, that helps doctors work out how likely a man is to have prostate cancer. But there is currently no national screening programme for prostate cancer.

This is because the PSA test isn’t as reliable as we would want a screening test to be. And there isn’t enough evidence that the benefits of PSA testing outweigh the harms.

What is the PSA test?

PSA or prostate-specific antigen, is a chemical produced by the prostate. PSA levels can be measured in the blood and are often raised when a man has prostate cancer. But they can also be raised when a man has a less serious condition called benign prostatic hyperplasia, which causes the prostate gland to enlarge.

Testing for PSA is complicated by the fact that all men have slightly different levels of PSA, so it is hard to say what level is ‘normal’, and what is ‘high’. This means that not all men with high PSA levels have prostate cancer. And not all men with prostate cancer have high PSA levels.

Why is there no national prostate cancer screening programme?

At the moment, there are too many uncertainties with the PSA test for doctors to use it in a national screening programme.

  • It misses a large number of cancers. Up to one in five men with prostate cancer have normal PSA levels.
  • It produces too many false alarms. Up to two in three men with high PSA levels do not have prostate cancer. But they will have to undergo the worry of further tests.
  • We cannot tell if a tumour is slow-growing or aggressive. By the age of 80, many men have cancer cells in their prostate, but most are not life-threatening. The PSA test could lead to some men having unnecessary treatment for a tumour that would not have caused them any problems.
  • We do not know if a screening programme would reduce the number of men dying from the disease. Two large studies have recently been published, from Europe and America. But the American study found that there was no reduction in deaths, while the European study found that deaths were reduced by 20%. Because of these conflicting results, we’re not sure yet whether screening could reduce prostate cancer deaths.

So what is being done for prostate cancer?

Instead of an organised screening programme, there is a programme called Prostate Cancer Risk Management, where men can ask to take the PSA test through their GP, if they want to.

They will be given information to explain the advantages and disadvantages of the test. If you would like to have a PSA test, speak to your GP about whether it is right for you.

Our current research

You can read all about the research we are doing into prostate cancer screening on our research highlights pages.

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Updated: 25 September 2009