The NHS will not be inviting all men over a certain age to be checked for prostate cancer like it does for some other cancers.

The UK National Screening Committee has recommended that the prostate specific antigen (PSA) test is only proactively offered to men with the BRCA gene mutation which puts them at higher risk. However, men can still get a PSA test from their GP under specific circumstances.

Olympic cycling legend Sir Chris Hoy, who has got a terminal diagnosis, is among campaigners arguing that men with known risk factors should be invited to have a PSA test once they reach a certain age, regardless of whether they are experiencing symptoms.

READ MORE: Prostate cancer expert explains how one wrong PSA test can harm a man’s life

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What is the PSA test?

A prostate-specific antigen (PSA) test measures the level of PSA in a sample of your blood. PSA is a protein made by your prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes the fluid part of semen.

The NHS says testing may be recommended if you have symptoms that could indicate prostate cancer, such as:

• peeing more than usual, having a sudden urge to pee or getting up often in the night to pee


• blood in your pee


• problems getting or keeping an erection

However for most people experiencing symptoms, particularly urinary symptoms, these will be being caused by something other than cancer.

A PSA test is usually done at your local hospital or GP surgery, by a nurse or other healthcare professional. Men are asked to refrain from certain activities in the 48 hours before a test and they can raise PSA levels and make the test result inaccurate. These include doing anything that leaves you out of breath, such as exercise.

If men have a raised PSA level they may then be offered another PSA test to check if levels are still high. If so the GP may refer to a specialist for further tests such as a biopsy and an MRI scan.

Why is screening so controversial?

Evidence suggests PSA levels can rise for many reasons, including simple infections, and 75% of people with a raised PSA do not have prostate cancer. A raised level means men can be referred for unnecessary biopsies or MRI, or treated for tumours that may never cause harm.

The PSA test can also miss aggressive cancer. Evidence has suggested around 15% of people with a normal result may actually have prostate cancer.

Who can currently get the PSA test?

Routine PSA testing is not currently offered on the NHS. You may be offered a PSA test if a doctor thinks you have symptoms that could be prostate cancer. If you're having treatment for a prostate condition you may be offered regular PSA tests to check how the treatment is working.

Men aged 50 or over can ask their GP for a PSA test, even if they do not have symptoms. However campaigners have argued many men don’t know they are at increased risk of prostate cancer and should be proactively encouraged to consider having a PSA check.

Men with a relative who has had prostate cancer can also request a PSA test once they reach age 50. If concerned, speak to your GP.

Who else could get it?

If the UK National Screening Committee recommendation is confirmed by Government next year then men with the BRCA gene mutation could also be invited for a PSA test. Men who suspect a relative may have had the BRCA gene mutation could request a genetic test on the NHS to confirm this.

The BRCA gene test looks for DNA changes that also increase the risk of breast cancer and ovarian cancer. It uses a sample of blood or saliva to look for the changes.

What sort of family history of prostate cancer means a man should request a NHS test for the BRCA gene mutation?

Top prostate surgeon Professor Freddie Hamdy explained: “This is a really good question because we see this all the time in men who come to our clinics. The first question we ask is whether they have anyone in the family with breast, ovarian or prostate cancer.

“The most common thing they say is ‘yes, my father died’. And then we ask what age he was when he was diagnosed and they say 74. "And then we ask what age he died and they say aged 92 - of a stroke. That is not a family history which is relevant for [genetic] testing.

“On the other hand we would have someone come in his early 50s and he says his father had prostate cancer and had surgery. Or ‘my father had prostate cancer and he’s on hormone therapy now’. That is a serious family history.

“Otherwise all you do is clinical genetic testing without any benefits at all and you increase the anxiety, because then the man thinks of his children, his sons, he thinks of his daughters. So it's a very careful balance between identifying the correct, high risk and doing the testing.”