The Controversy Surrounding PSA Testing Explained

The survival rate of prostate cancer has tripled in the last 50 years. This is largely due to the availability of PSA testing which can be requested by men aged 50 or older from their GP, even without symptoms.

Whilst PSA is the primary measure of prostate abnormality, the UK National Screening Committee (NSC) do not currently recommend routine screening. With recent news of Sir Chris Hoy’s prostate cancer diagnosis at aged 48 this poses the question, why?

What is PSA testing?

PSA (Prostate Specific Antigen) is a blood test used to measure abnormality within the prostate.

According to NICE, “the aim of PSA testing is to detect early prostate cancer when treatment can be offered that may cure cancer or extend life”.

Men with prostate cancer tend to have higher levels of PSA in their blood. As 55,000 men are diagnosed with prostate cancer in the UK every year, PSA testing provides a quick and efficient way to streamline diagnosis and improve outcomes.

A PSA test is recommended if you are:

• Aged 50 or older
• Have a family history of prostate cancer
• Are of black ethnic origin

The controversy

PSA levels may increase with conditions such as prostatitis, urinary tract infection (UTI), or prostate enlargement, therefore an elevated PSA level does not mean you have prostate cancer.

There is also a correlation between PSA and BMI. High BMI causes lower PSA levels meaning a PSA test is unsuitable due to inaccuracy of results. In summary, no level of PSA is truly diagnostic.

Advanced PSA

The Advanced PSA test has been designed to build on traditional PSA to provide a more informative pathway for both clients and practitioners. Using a novel combination of biomarkers including PSA, a Prostate Cancer Risk Score can help to more accurately identify individuals at a higher risk of prostate cancer compared to a standalone PSA test. Those at lower risk are reassured and will not require unnecessary, invasive procedures.

A Personal Account

Ralph McCutcheon, aged 76, had a PSA test through a local Randox Health clinic. His PSA result was 7.6 and after being fast-tracked through the NHS, was categorised as high risk of prostate cancer and diagnosed with an 11mm tumour within 1 week.

"To any man reading this, I would urge you to have this simple PSA test done regularly. Forewarned is forearmed! The earlier these things are found the easier they are to treat."

Read his story in full here.

In conclusion

Early detection of prostate cancer can save lives. For those considered to be high risk due to a family history, ethnicity, or BMI, PSA testing can prove an important tool to monitor and diagnose. It is up to consider the options when it comes to prostate cancer testing. It could potentially save your life.

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