PSA stands for prostate-specific antigen. It is a protein made in the prostate that can be measured in the blood. A raised PSA can be caused by prostate cancer, but much more often it is caused by something benign.
In Denmark, it is not recommended that healthy men without symptoms are screened for prostate cancer with PSA. This applies both to organised screening and to one-off measurements "just to be safe". The reason is that large studies have not shown a clear survival benefit, while many men go through tests and treatment they did not need.
This does not mean you cannot have your PSA measured. But it does mean you should know both the pros and cons before you choose. That is why we have written this page.
Danish recommendations suggest that a PSA measurement can make sense for the well-informed man who has an increased risk. This applies, for example, to men over 45 with prostate cancer in their close family and men over 40 with a known BRCA2 mutation - who are otherwise in good health.
Reasons to consider a PSA test:
You have prostate cancer in your close family, for example a father or brother who got the disease before 60, or several relatives with the disease.
You have been found to have a BRCA2 mutation.
You have read up on the pros and cons and want to know your number.
What you should know about the downsides:
False positive results. A raised number without cancer can lead to worry, more tests and in some cases a biopsy of the prostate.
Overdiagnosis. You may be diagnosed with a slow-growing cancer that would never have caused you problems.
Overtreatment. Treatment for prostate cancer can cause lasting side effects. Many men get erection problems, and some have problems holding their urine.
False reassurance. A normal result does not rule out disease.
If you have symptoms, see your own doctor. If you have, for example, difficulty passing urine, blood in your urine or semen, pain in the perineum or bone pain, contact your own doctor - do not use a private blood test instead. Urinary symptoms are most often caused by benign enlargement of the prostate, but a doctor needs to assess you as a whole and can examine you in a way a blood test cannot.
You do not need to fast before a PSA test. However, some things can give a temporarily raised number. Lægehåndbogen recommends, among other things, waiting:
at least 24 hours after ejaculation
at least 3 weeks after a bladder infection
6-8 weeks after inflammation of the prostate
3 weeks after prostate massage or a prostate biopsy, and 1 month after prostate surgery
If you currently have signs of a urinary tract infection, such as stinging when you pass urine or a frequent urge, wait with the test and contact your own doctor. If you take medicine for an enlarged prostate or cholesterol-lowering medicine, it can lower PSA. Tell the doctor who will assess your result.
We do not make diagnoses, and we do not carry out investigations. If your PSA is above the decision limit for your age, we recommend that you contact your own doctor. The doctor assesses your result together with your age, your symptoms, your family history and any previous measurements.
The doctor will often repeat the measurement. It is your doctor's decision whether there is reason for further tests or a referral to the Danish Health Authority's cancer pathway for prostate cancer. According to Lægehåndbogen, it is typically a suspicious prostate on examination or two raised PSA measurements that lead to a referral. We will contact you if a result needs prompt action.
