Condition

Raised PSA

A raised PSA result can be worrying — but it is not the same as a diagnosis of cancer. Here's what it means, and what happens next.

What is PSA?

PSA (prostate-specific antigen) is a small protein released by the prostate gland, normally as part of semen, with a very small amount also entering the bloodstream. As the prostate naturally enlarges with age, it tends to produce more PSA — so blood levels usually rise gradually over time even without any disease being present.

A raised PSA is not a diagnosis

The PSA test is not a specific test for cancer. Levels can also be raised by an enlarged prostate, inflammation or infection, recent ejaculation, vigorous exercise in the 48 hours beforehand, or recent procedures involving the prostate, bladder or urethra.

What raises the chance of prostate cancer?

Having a father or brother who has had prostate cancer
Black-African or Black-Caribbean heritage
Carrying a BRCA gene mutation
Obesity

As a general guide, among men with a PSA between 3 and 10, roughly a quarter are found to have prostate cancer on biopsy; above a PSA of 10, this rises to around half. These are population guides rather than a prediction for any individual — many men with a raised PSA in this range do not have cancer.

What happens next

If your PSA is raised, your GP may repeat the blood test to confirm it, check a urine sample to rule out infection, and review your general health. If levels remain raised, you'll usually be referred to a urologist through the fast-track (2-week wait) pathway.

1
Initial assessment
Often an initial telephone assessment with a urologist or specialist nurse to review your history and results.
2
Detailed MRI scan (mp-MRI)
A detailed MRI scan of the prostate (multi-parametric MRI), which can identify whether there are any areas that look suspicious.
3
Result & next step
A clear scan significantly lowers the likelihood of a significant cancer being present; a suspicious or uncertain scan may lead to a targeted biopsy.
4
Ongoing care
If no biopsy is needed, you'll usually be given a personalised PSA threshold for future monitoring. If cancer is found, results are reviewed by a full specialist team before treatment options are discussed with you.

If a biopsy is needed

Biopsies are examined under a microscope to confirm whether cancer is present and, if so, to grade it. Results are usually available within a couple of weeks and are discussed at a multi-disciplinary team (MDT) meeting — bringing together several specialists to consider your individual case — before your urologist talks through the findings and options with you.

Information on this page follows patient guidance published by the British Association of Urological Surgeons (BAUS).