PSA test for prostate cancer

Why some men have not had a PSA test

Some men living in the UK have not heard of the PSA test or thought about it seriously, while others have thought about it carefully. Here we summarise the views of men we talked to who had either decided not to have the test for the moment, or were still thinking about it (also see 'The pros and cons of a national screening programme for prostate cancer'). 

Some men told us that their GPs had told them about PSA testing while also making it clear that they were not in favour of doing the test without good reason (also see 'Deciding whether or not to have the PSA test' and 'Finding information about the PSA test'). 

A man who thought he was at low risk for getting prostate cancer due to a chromosome condition that affected the level of androgen in the blood, and who had been influenced by articles in the press that were opposed to the PSA test, also listened to the advice given by his GP, so initially decided not to have the test. However, recently he has changed his mind, mainly because of peer pressure, and may have the test during the next few months. 

The men who had decided fairly firmly not to have a PSA test in the absence of symptoms gave many reasons. Some, like the man quoted above, thought they were not in a high-risk group.

Some men said that they didn't want to become neurotic or obsessed about their health. They also worried that the PSA test itself was unreliable, giving false positive results (an abnormal test result that occurs when there is no problem) and false negative results (a test result that suggests that all is well when in fact there is a problem). 

Men's views were also affected by what they had learnt about the prostate biopsy, an investigation which is usually recommended after an abnormal PSA test result (see also 'Biopsy of the Prostate'). 

Some men knew that elderly men often have 'latent' prostate cancer where they are not affected by the disease and eventually die of something else. This also influenced their decision not to have the test now.

Some men were also aware of the conflicting evidence about whether or not treatment for early prostate cancer prolongs life. They also knew that treatment may cause unpleasant side effects. This persuaded some that they should not have a PSA test unless they had quite serious symptoms.

Last reviewed May 2016.

Last updated May 2016.

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