A PSA test is a blood test that helps detect prostate cancer early. There is no national screening programme in the UK, so men have to ask. Mr Nargund offers PSA testing with a consultation, so the result is interpreted properly, and an MRI-first pathway if it is raised, which avoids unnecessary biopsies.
Prostate cancer is the most common cancer in men in the UK, and the one with the best outlook when it is found early. There is still no national screening programme, which means the decision to check is yours. Mr Vinod Nargund trained in urological cancer at Memorial Sloan Kettering in New York and has spent 48 years diagnosing and treating prostate cancer. He offers PSA testing as part of a consultation, not as a number in isolation, because the number on its own is easy to misread.
Who should have a PSA test?
Men over 50 are entitled to a PSA test on request, and men at higher risk should consider one from 45. Higher risk means having a father or brother who had prostate cancer, being Black, or carrying a BRCA gene change. Men with symptoms such as a weak flow, getting up at night, or difficulty starting to pass urine should be assessed whatever their age, although those symptoms are more often caused by a benign enlarged prostate than by cancer.
What does a PSA result mean?
PSA is a protein made by the prostate, and the level rises with age, with a benign enlarged prostate, with infection and after ejaculation or cycling, as well as with cancer. A raised PSA does not mean you have cancer, and a normal PSA does not completely rule it out. This is why Mr Nargund interprets the result alongside your age, your history and an examination, and why he sometimes repeats the test before doing anything else.
What happens if my PSA is raised?
The pathway has changed a great deal in the last few years, and for the better:
- MRI scan first. A detailed prostate MRI shows whether there is an area that looks suspicious. Many men with a raised PSA have a clear scan and can avoid a biopsy entirely.
- Targeted biopsy only if needed. If the MRI shows something, a small number of samples are taken from that exact area, which is more accurate and better tolerated than the older random biopsies.
- A plain explanation of the result. Many prostate cancers are slow growing and are safely monitored rather than treated. Others need treatment, and Mr Nargund will set out the options clearly and give you time.
Prostate cancer screening as part of a wider check
A PSA test sits naturally inside a men’s health screening, which also checks the testicles, bladder and kidneys, and can be combined with a review of urinary symptoms. If you already have symptoms, see lower urinary tract symptoms and prostate care.
Sources
NHS guidance on PSA testing and the Prostate Cancer Risk Management Programme, NICE guideline NG131 on prostate cancer diagnosis and management, and Prostate Cancer UK patient information.
Reviewed by Mr Vinod Nargund, MBBS, PhD, FRCS(Urol), FEBU. Last updated 12 September 2026.