Prostate cancer is one of the most common cancers affecting men. The PSA blood test can help detect cancer early when a potentially fatal prostate cancer is still curable, but it can also identify slow-growing cancers that may never cause harm.
This balance — finding significant cancers early while avoiding unnecessary diagnosis and treatment — is why prostate cancer screening remains an important and evolving topic.
What has changed?
In 2026, the UK National Screening Committee recommended targeted screening for men aged 45 to 61 who have a BRCA2 gene variant and a family history of breast, ovarian, pancreatic or prostate cancer. For this group, PSA testing every two years is recommended.
This is not the same as screening all men. Routine PSA screening for the whole male population is still not recommended, because the test can lead to overdiagnosis, unnecessary biopsies, anxiety and treatment side effects.
Why is PSA screening so complex?
The PSA test measures prostate-specific antigen in the blood. A raised PSA can be linked to prostate cancer, but it can also be caused by benign prostate enlargement, infection, inflammation or other non-cancerous factors.
That is why PSA testing works best as part of a wider risk assessment, taking into account age, family history, ethnicity, genetic risk and, where appropriate, MRI scanning before biopsy.
Should we do screening for prostate cancer in the UK?
Simon Bott, Consultant Urological Surgeon at Urology Partners says “PSA testing for men aged 50-69 years old saves lives from prostate cancer. These men frequently have no symptoms. Screening, invites men to come to have a PSA blood test irrespective of their symptoms, where they live, or if they are seeing a Dr for other reasons. These are the men that benefit most from a PSA blood test.
Currently PSA testing may be done if a man has urinary symptoms (which are unlikely to be related to any cancer in their prostate). Also, if you request a PSA blood test from your GP, the doctor is obliged to perform the test if you are aware of the risks and benefits.
This current UK wide approach of testing men with symptoms or just asking for test from their GP does not target the groups of men who are most likely to benefit. As a result there are currently 10,000 men a year who are over diagnosed with prostate cancer which has a detrimental effect on them due to the side effects of treatment and their mental wellbeing. A national screening programme will remove the pressure on GP’s for PSA testing and allow men to be risk categorised at a younger age which reduces the chance of late diagnosis without the issue of over diagnosis.”
His point highlights the need for a more organised, risk-based approach that helps identify men most likely to benefit from testing while reducing unnecessary harm.
Overdiagnosis can have a real emotional impact. Being told you have cancer can affect mental wellbeing, even when that cancer is unlikely to progress or need immediate treatment.
Who should think about their risk?
We support any man aged 45-69 having a PSA test, if their life expectancy exceeds 10-15 years, However, some men are at higher risk of having prostate cancer that matters. Risk is higher with increasing age, a family history of prostate cancer, inherited gene changes such as BRCA2, and Black ethnicity. Men aged 50 and over can discuss PSA testing with their GP, while men at higher risk may wish to have that conversation earlier, particularly from the age of 45.
Symptoms that should prompt medical advice include difficulty passing urine, a weak flow, passing urine more often, blood in the urine or semen, unexplained pelvic or back pain, or new erectile dysfunction. These symptoms are not usually due to prostate cancer, but can be improved with lifestyle changes, medication or sometimes surgery.
Where are we now?
We are moving towards a more personalised approach to prostate cancer detection, using risk assessment, MRI-led pathways, genetic testing for selected men and new research to understand who should be screened and when.
For now, the key message is that men should understand their individual risk and seek advice if they are concerned. Screening is no longer simply about whether every man should have a PSA test; it is about identifying who is most likely to benefit.
At Urology Partners, we support informed, evidence-based conversations about prostate cancer risk, PSA testing and modern diagnostic pathways. If you are unsure whether you should be tested, speaking to a specialist can help you make the right decision for you.