Whilst these pages are in the process of being updated, please refer to the Scottish urological cancer guidelines:
https://www.cancerreferral.scot.nhs.uk/urological-cancers/?alttemplate=Guideline
R.M & H.S 13-05-20
Who to refer
Men with raised PSA according to the following age-adjusted limits:
- Age 59 years or less: PSA greater than or equal to 3.0μg/l
- Age 60 to 69 years: PSA greater than or equal to 4.0μg/l
- Age 70 or over: PSA greater than or equal to 5.0μg/l
Before having a PSA test men should NOT have:
- an active urinary infection (PSA may remain raised for many months)
- ejaculated in the previous 48 hours
- exercised vigorously in the previous 48 hours
- had a prostate biopsy in the previous 6 weeks
- had a DRE within the previous week
- Prostate Cancer Risk Management Programme – PSA Testing [Adobe Acrobat PDF – 670KB]
Who not to refer
- Men who have a raised PSA as a result of urinary tract infection or recent urinary tract instrumentation or catheterisation.
- Where the PSA is raised in these situations, it should be repeated six weeks later.
- Referral is indicated if it remains elevated.
- If there is a downward trend, it can be monitored until it returns to normal.
- Men with significant co-morbidities, especially those aged 70 or over, should not undergo prostate biopsy without careful consideration of whether a diagnosis of prostate cancer is in their interests.
- Please indicate any such co-morbidities on the referral and we will arrange for clinic consultation before biopsy is indicated.
- PSA testing in elderly men is not recommended unless a diagnosis of prostate cancer is relevant to that particular patient’s situation, and will affect their management.
How to refer
- Via SCI Gateway.
