Serum PSA

Specimen Required

3-5cc Clotted Blood or Serum

Fasting Required

Purpose of the Test

To help detect and to monitor prostate cancer

When this test is required

Current evidence does not indicate that screening asymptomatic men for prostate cancer would reduce mortality, the Department of Health’s Prostate Cancer Programme has developed the Prostate Cancer Risk Management Programme. This is explained under Without symptoms of prostate disease aged 50 and over.Currently there is no evidence to show that the overall benefits of a PSA- based screening programme outweighs the risks. PSA is still a poor test for prostate cancer detection (low specificity) and it has led to harm of over-diagnosis and over-treatment in up to 50 % of men. A PSA test does not distinguish a slow-growing cancer from a fast-growing cancer.Risk factors for prostate cancer include:•Increasing age•Black ethnicity•Family history of prostate cancer•Being overweight or obese (especially in advanced prostate cancer)Your healthcare professional will take these risk factors into account to give you the best available information and support your decision.The Public Health England website has a guidance document on Prostate Cancer Risk Management Programme (PCRMP). It includes a summary sheet on advice for well men aged 50 and over.

What the Test Detects

Blood is being tested for the amount of PSA it contains. PSA is a protein produced mainly by cells in the prostate gland and can be a useful indicator of prostate cancer. This protein can be found in all people with a prostate; however raised levels may indicate an infection of the prostate gland (prostatitis), benign prostate enlargement or prostate cancer. In blood, PSA is present both as free PSA and as complexed PSA bound to other blood proteins. The free PSA test measures the percentage of the total PSA that is not bound to proteins in the patient’s blood.See MoreSee Less

Preparation for the Test

Avoid ejaculation for 48 hours before sample collection as this has been associated with elevated prostate specific antigen (PSA) levels; the sample should also be collected prior to your healthcare professional performing a digital rectal exam (DRE) and prior to, or 6 weeks after, a prostate biopsy. PSA may remain high for many months following a urinary tract infection, and for 48 hours following vigorous exercise, especially riding a bicycle).

Sample Requirements

A blood sample is taken by needle from a vein in the arm. You are likely to be advised to avoid ejaculation and vigorous physical activity affecting the prostate, such as bicycle riding, during the two days before the blood test. A blood sample should not be taken until at least a week after a digital rectal examination.

Additional Notes

Prostate biopsy or operations on the prostate will significantly elevate PSA levels. A blood test for PSA measurement must be performed before surgery or six weeks after.Ejaculation and vigorous physical activity affecting the prostate, such as bicycle riding, may cause a temporary rise in PSA. A blood sample should be taken either before a digital rectal examination, as pressure on the gland during the examination will lead to an increase in the PSA value, or alternatively after at least a week after the examination. Some chemotherapeutic drugs, such as cyclophosphamide, methotrexate, and also other medications such as aspirin, statins, diuretics, finasteride, and dutasteride may affect PSA results. Before a PSA test, people should not have an active urinary infection or had one within the previous 6 weeks.

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