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Updated guidance for GPs on PSA testing for prostate cancer

Posted by: , Posted on: - Categories: Prostate cancer risk management

PHE Screening has published an updated information pack to help GPs and primary care professionals advise well men aged 50 and over about prostate specific antigen (PSA) testing for prostate cancer. 

A GP talking to an older male patient.
Photo courtesy of Prostate Cancer UK

The PSA test measures the level of PSA in a man’s blood and is the most common initial test for men worried about prostate cancer. However, it is not accurate enough for the UK National Screening Committee (UK NSC) to support it as the basis for a screening programme, which is why the UK NSC's recommendation is not to offer screening for prostate cancer.

A raised PSA level can mean a man has prostate cancer, although in some cases it may miss identifying a cancer risk. It can also falsely identify a possible risk of prostate cancer, or find a slow growing cancer that may never cause symptoms or shorten life. This may result in some men opting to have unnecessary treatments with side effects that can affect daily life.

The NHS Prostate Cancer Risk Management Programme (PCRMP) has been revised following a rigorous review involving input from GPs, clinicians and patients. It gives clear and balanced guidance on the potential benefits and risks of having the test.

GPs and primary care professionals should only use the PCRMP to counsel asymptomatic men aged 50 and over who proactively ask about PSA testing for prostate cancer. It does not apply to their consultations with men at high risk or men with symptoms of any age.

The revised PCRMP pack includes:

GPs should download and print out copies of the patient information summary sheet as required when counselling well men aged 50 and over.

Dr Anne Mackie, PHE’s Director of Screening, said:

The decision about whether a man takes a PSA test is a complex one and has to be thought through carefully.

There are potential harms as well as benefits in taking the test and we know that many men really appreciate the opportunity to discuss the test with their GP.

Our new information pack will make it easier for GPs to have this conversation with their patients, and assist men in making a decision that is right for them.

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  1. Comment by Alaina Albert posted on

    Thanks for the blog! The guidelines for GPs and primary care professionals are very helpful.

  2. Comment by phil Williams posted on

    The GP guide is very helpful, but the patient leaflet is unfortunately not nearly as good as its predecessor. It should include "how to avoid a false positive" eg avoid ejaculation, heavy exercise etc.Until it does, we'll stick with the old leaflet

    • Replies to phil Williams>

      Comment by Mike Harris posted on

      The revised PCRMP resources incorporate the latest evidence and statistics around PSA testing for prostate cancer. We would therefore advise against using the old materials now as they are outdated. The summary information sheet for men is intended to be printed and given to men as part of a wider discussion with the GP about PSA testing and prostate cancer. It should be used in conjunction with the summary sheet for GPs and the full evidence document, which include information for discussion with men about the practicalities of taking the PSA test.