Prostate cancer is the most common cancer in men in the UK, yet many men know very little about their prostate until a problem arises. Understanding PSA testing — what it can and cannot tell you — is one of the most valuable things a man over 40 can do for his health.

What is the prostate and why does it matter?

The prostate is a small, walnut-sized gland that sits just below the bladder and surrounds the urethra. Its primary role is to produce seminal fluid. For most of a man's life it causes no problems — but from around the age of 40 onwards, changes in prostate tissue become increasingly common.

Two conditions account for the majority of prostate-related symptoms: benign prostatic hyperplasia (BPH), an enlargement of the prostate that is not cancerous but can cause significant urinary symptoms; and prostate cancer, which is the most commonly diagnosed cancer in men in the UK, with over 52,000 new cases each year.

Awareness, monitoring, and timely assessment are the most powerful tools available to men when it comes to prostate health.

What is PSA and what does the test measure?

PSA stands for prostate-specific antigen — a protein produced by cells in the prostate gland. Small amounts are normally present in the blood, but when prostate tissue is disturbed — whether by cancer, inflammation, or benign enlargement — PSA levels can rise.

The PSA blood test measures the concentration of PSA in the blood, expressed in nanograms per millilitre (ng/mL). It is a simple, straightforward blood test — but interpreting the result requires clinical judgement, because PSA is not a cancer-specific marker.

Our blood testing service can include PSA as part of a broader men's health panel, with a clinician available to discuss your results in context.

What is a normal PSA level?

PSA reference ranges vary with age, as the prostate naturally grows over time and PSA levels tend to rise accordingly. As a general guide:

Age 40–49: up to 2.5 ng/mL is generally considered within the normal range.
Age 50–59: up to 3.5 ng/mL.
Age 60–69: up to 4.5 ng/mL.
Age 70 and over: up to 6.5 ng/mL.

These are population-level thresholds, not absolute rules. A result within the "normal" range does not definitively exclude prostate cancer, and a raised result does not confirm it. What matters is the combination of your PSA result, your individual risk factors, your symptoms, and the clinical assessment as a whole.

Why a raised PSA does not always mean cancer

This is the most important thing to understand about PSA testing, and the reason it is so frequently misunderstood. A raised PSA can be caused by several conditions that have nothing to do with cancer:

Benign prostatic hyperplasia (BPH). The most common cause of a raised PSA in men over 50. BPH is a non-cancerous enlargement of the prostate that is extremely common with age.
Prostatitis. Inflammation of the prostate — often caused by infection — can temporarily elevate PSA significantly.
Recent ejaculation. PSA levels can be temporarily raised for 24 to 48 hours after ejaculation, which is why it is recommended to abstain for 48 hours before a PSA test.
Vigorous exercise. Particularly cycling, which can cause mechanical pressure on the prostate.
Urinary tract infection or urinary catheterisation. Both can cause temporary elevation.

This is why context matters. A raised PSA result is a prompt for further investigation, not a diagnosis. It opens a clinical conversation — it does not close one.

What happens if your PSA is raised?

If your PSA result comes back above the age-adjusted threshold, the next step is typically a repeat test and a discussion with your doctor about your personal risk profile. Factors that are considered alongside PSA include:

Family history. Men with a father or brother diagnosed with prostate cancer before the age of 60 are at significantly higher risk.
Ethnicity. Black men are statistically at higher risk of prostate cancer and of developing it at a younger age.
Urinary symptoms. Frequency, urgency, weak stream, or incomplete emptying can all indicate prostate changes worth investigating.

Where further investigation is warranted, this typically involves an MRI scan of the prostate, which has significantly improved the accuracy of prostate cancer detection in recent years. Biopsy — guided by MRI findings — is used to confirm or exclude cancer where the imaging suggests concern.

Who should consider PSA testing?

There is no national screening programme for prostate cancer in the UK — unlike bowel cancer or breast cancer — primarily because of the complexity of interpreting PSA results and the risks of over-treatment of slow-growing cancers that might never cause harm. This is a genuine clinical debate, not a failing.

However, many clinicians — and many men — choose to pursue PSA testing on an informed, proactive basis. The guidance is broadly as follows:

Men over 50 should be aware of the PSA test and can request it following an informed discussion with their doctor.
Men over 45 with a family history of prostate cancer, or Black men over 45, should consider discussing PSA testing earlier.
Any man experiencing urinary symptoms, pelvic pain, or blood in urine or semen should seek assessment promptly, regardless of age.

Our health screening service includes PSA testing as part of a comprehensive men's wellbeing panel, alongside cardiovascular risk, metabolic markers, and a full clinical review.

Taking a proactive approach

Prostate health is not something to leave to chance or to raise only when symptoms appear. Many prostate cancers, when caught early, are entirely treatable. The challenge is that early prostate cancer is often entirely symptom-free — which makes proactive monitoring genuinely valuable.

AtWell's approach to men's health is grounded in informed decision-making. We explain what tests mean, what the results tell us, and what the appropriate next steps are — without alarm, and without dismissiveness. Men deserve clear information and a clinical partner who takes their health seriously.

Prostate health: what men need to know about PSA testing