Understanding PSA Testing and Modern Follow-Up for Prostate Cancer Concerns

sarah_yelland
Nov 9
3 min read

Prostate cancer affects a significant number of men in the UK, with about 1 in 8 men diagnosed during their lifetime. For Black African-Caribbean men, the risk is even higher, with 1 in 4 affected. Despite these numbers, testing for prostate cancer is often inconsistent and misunderstood. Many men do not know when or how to get tested, and some assume it is part of routine health checks when it is not. This November, it is vital to raise awareness about prostate cancer risks, the role of PSA testing, and the modern follow-up procedures that help manage raised PSA levels effectively.

Who Is at Risk of Prostate Cancer?

Understanding who is at risk helps men make informed decisions about testing and early detection. The main risk factors include:

Age over 50: The chance of developing prostate cancer increases as men get older.
Black African or Caribbean heritage: Men from these backgrounds face a higher risk, with incidence rates around 1 in 4.
Family history: Having a father or brother diagnosed with prostate cancer raises your risk.
Family history: having a Mother or sister diagnosed with breast cancer due to the BRACA gene increases your risk.
Lifestyle factors: Obesity and lack of physical activity may contribute to increased risk.

Men with these risk factors should be particularly aware of symptoms and consider discussing PSA testing with their healthcare provider.

What PSA Testing Involves and Why It Matters

There is no national screening programme for prostate cancer in the UK. This means testing is usually done on an individual basis, often initiated by the patient rather than automatically offered by doctors.

What Is a PSA Test?

The PSA test measures the level of prostate-specific antigen in the blood. PSA is a protein produced by the prostate gland, and higher levels can indicate prostate problems, including cancer. However, a raised PSA level is not a diagnosis of cancer on its own. It signals the need for further investigation.

PSA blood test vial used for prostate cancer screning

Preparing for an Accurate PSA Test

Certain activities and conditions can cause a false rise in PSA levels. To get the most accurate result, avoid the following for 48 to 72 hours before your test:

Ejaculation
Cycling or vigorous exercise
Urinary tract infections
Recent prostate procedures such as catheterisation or a digital rectal exam (wait at least six weeks)

Following these guidelines helps reduce the chance of unnecessary worry or further tests.

What about the examination? Digital Rectal Exam (DRE)

A digital rectal exam (DRE) involves a healthcare professional examining the prostate through the rectum to check for any abnormalities. This exam is optional and is primarily used when symptoms indicate benign prostatic hypertrophy (BPH), which is a non-cancerous enlargement of the prostate. It is important to note that a DRE is not essential for cancer screening. Do not let the fear of this exam prevent you from getting your PSA levels checked. While you may be offered a DRE, it is not necessary for everyone and should not be a barrier to testing.

When Should You Consider Getting Checked?

Knowing when to get tested can make a big difference in early detection and treatment outcomes.

Men aged 50 and over should consider having a PSA test, especially if they have no symptoms but want to be proactive.
Men with Black African or Caribbean heritage or a family history of prostate cancer should consider testing from age 45.
Men experiencing urinary symptoms such as terminal dribbling, frequent urination at night (nocturia), or a weak urine stream should seek medical advice promptly.

Practical Steps to Take Control of Your Prostate Health

Talk openly with your healthcare provider about your risk factors and whether PSA testing is right for you.
Keep track of any urinary symptoms and report changes promptly.
Prepare properly for PSA tests by avoiding activities that can affect results.
Understand that a raised PSA is not a diagnosis but a signal for further checks.
Stay informed about modern follow-up options that reduce unnecessary procedures and improve care.

Prostate cancer awareness and testing can save lives. By understanding the risks, knowing when to get tested, and trusting modern follow-up methods, men can take control of their prostate health with confidence.

Missed a Free PSA Hub?

Don’t worry—many mobile clinics travel the UK offering free PSA checks, especially during awareness months. If you missed one, you can still access testing through your NHS GP or a private provider.

At Pembrokeshire Medical Group, we offer: