The PSA test is the most widely used prostate check for men — but it's also one of the most misunderstood. A raised result doesn't automatically mean cancer, and a normal one doesn't guarantee all is well. Understanding what PSA actually measures helps you make a sensible, informed decision about testing.
What is PSA?
PSA stands for prostate-specific antigen, a protein made by the prostate gland. A small amount leaks into the bloodstream normally, and it can be measured with a simple blood test. Because prostate conditions — including cancer — tend to raise the amount released, PSA is used as an early warning marker worth investigating further.
Why the prostate matters
The prostate is a small gland that sits below the bladder and helps produce semen. It naturally enlarges with age, which is why urinary symptoms become more common in older men. Prostate cancer is one of the most common cancers in men, and it's often slow-growing and treatable when found early — which is the case for checking.
Who should consider a PSA test?
There's no universal screening programme in the UK, so testing is an individual decision — but it's worth discussing if you are:
- Aged 50 or over
- Aged 45 or over with a family history of prostate cancer (father or brother)
- A Black man aged 45 or over, as the risk is higher in this group
- Experiencing urinary symptoms such as a weak flow, needing to go more often, or getting up at night
What raises PSA besides cancer?
Several harmless things can push PSA up, which is why context matters. Common causes include an enlarged prostate (very common with age), a urine or prostate infection, recent ejaculation, vigorous cycling, and recent procedures involving the bladder or prostate. For an accurate result, it's usually best to avoid ejaculation and hard cycling for a couple of days beforehand.
The free-to-total PSA ratio
PSA travels in the blood in two forms — "free" and "bound". Measuring free PSA alongside total PSA and looking at the ratio between them can give a more refined picture when the total is borderline, helping distinguish benign enlargement from changes that need closer attention.
Check your prostate (PSA)
Our Complete Prostate Profile measures free PSA, total PSA and the PSA ratio together — a fuller picture than total PSA alone.
Book a prostate checkThe limits of PSA — and why a doctor interprets it
PSA is a useful marker but an imperfect one: it can be raised without cancer, and occasionally normal when a problem exists. That's why a result is never read in isolation. Your age, symptoms, prostate size, previous readings and the trend over time all matter — so results should be discussed with a doctor who can advise whether any next steps are needed.
When to get checked
If you're in one of the higher-risk groups above, or you've noticed urinary changes, a PSA test is a reasonable first step to discuss. Knowing your baseline is valuable — a single number matters less than how it changes over the years.
Check your prostate (PSA) with OneMedicine
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Specialist interest: Cardiovascular Medicine · OneMedicine, CQC-registered clinic