What a prostate check can involve

Getting checked for possible prostate cancer does not mean there is one definitive test performed at the first appointment. Assessment can involve several stages, depending on your symptoms, risk and initial results.

Your healthcare professional may begin by asking about urinary changes, sexual function, other symptoms, medications and family history. In some healthcare systems, they may also offer or discuss a physical examination of the prostate.

PSA blood testing

One common part of an assessment is a PSA blood test. PSA is produced by prostate cells, and the test measures its concentration in the blood.

An elevated result does not automatically mean prostate cancer. According to the US National Cancer Institute, benign prostate enlargement and inflammation or infection of the prostate can also increase PSA.

This is why PSA testing is generally considered part of a wider assessment rather than a simple positive-or-negative cancer test.

Further investigation

If initial findings suggest further investigation is appropriate, additional tests can be offered.

In England, the NHS prostate cancer testing guide says people referred to a specialist because prostate cancer is suspected will have an MRI scan. A specialist may subsequently recommend a biopsy, in which tissue samples are taken from the prostate and examined for cancer cells.

Depending on the circumstances, additional imaging can also be used after diagnosis to assess the disease.

What screening does — and does not — include

Screening is testing someone who does not have symptoms. Diagnostic investigation is testing prompted by symptoms or other concerning findings. The distinction matters because countries have different policies for routine screening.

The US CDC identifies PSA as the main prostate cancer screening test and explains that some clinicians may also use a digital rectal examination.

What is included, whether you need a referral and whether there is a charge will depend on your healthcare system, insurance arrangements and clinical circumstances. Check your national health service or insurer before assuming a particular test is automatically covered.