Measures total PSA and free PSA, and reports the free-to-total PSA ratio. PSA (prostate-specific antigen) is a protein made by the prostate. A raised level has several possible causes, most of them not cancer, and a normal level does not rule cancer out. This test is for people with a prostate who have weighed up those trade-offs and want a private result to discuss with a clinician.
What is measured
- Total PSA (measured)
- Free PSA (measured)
- Free/total PSA ratio (calculated)
Useful for
- An informed decision to have a PSA test after considering the possible benefits and harms
- Adding free PSA information when total PSA is borderline, for discussion with a clinician
- Having a result to bring to your GP if you are concerned about your prostate cancer risk
PSA testing is not a screening test for the general population: the UK National Screening Committee advises against screening all men. If you have urinary symptoms (needing to pass urine more often or urgently, a weak flow, getting up at night) or blood in your urine, please see your GP rather than relying on a private test.
Sample: venous blood (serum). Biomarkers: 3 (2 measured, 1 calculated). Interpretation: not included in the test price; available separately.
Ultimate Prostate Check
- Total PSA (measured): the combined amount of free and bound PSA in your blood, reported in µg/L (equivalent to ng/mL). This is the main result used in UK clinical pathways.
- Free PSA (measured): the unbound portion of PSA.
- Free/total PSA ratio (calculated): free PSA divided by total PSA, usually shown as a percentage. A lower percentage has been associated with a higher probability of cancer, and a higher percentage more often with benign enlargement.
The laboratory counts this panel as 3 biomarkers: two measured and one calculated. Some laboratories report free PSA and the ratio only when total PSA falls within the range where the ratio is considered informative.
PSA is an enzyme made by the cells lining the prostate; its normal job is to thin semen. A small amount leaks into the bloodstream. More leaks when the structure of the prostate is disturbed, which can happen with benign enlargement, inflammation or infection, after procedures, and with cancer. This is why PSA is specific to the prostate but not to cancer.
Free and bound PSA
In blood, most PSA is bound to protective proteins (complexed PSA) and a smaller part circulates unbound (free PSA). Research has found that men with prostate cancer tend to have a lower proportion of free PSA than men with benign enlargement. In a prospective multicentre study of 773 men aged 50 to 75 with a total PSA of 4 to 10 ng/mL and a prostate that felt benign on examination, using a free PSA cut-off of 25% detected 95% of the cancers and would have avoided about 20% of unnecessary biopsies. The ratio is most informative in this borderline range and is not a stand-alone test for cancer.
Screening policy in the UK
In 2026 the UK National Screening Committee (UK NSC) recommended against prostate cancer screening for all men, concluding that the PSA test is not accurate enough to support wider screening and would put too many men at risk of overdiagnosis. It recommended a targeted programme for men aged 45 to 61 who have a BRCA2 gene variant and a family history of breast, ovarian, pancreatic or prostate cancer, with a PSA test every two years. Check the NHS website for the current position, as this policy is still being put into practice. The NHS states that men and anyone with a prostate can still ask a GP about PSA testing.
What happens after a raised PSA in the NHS
A raised result is usually repeated. If it remains raised, a GP may refer to a specialist, where an MRI scan and possibly a biopsy are used to look for cancer. NICE suspected-cancer guidance uses age-specific PSA thresholds for urgent referral and recommends considering a PSA test and examination in men with urinary symptoms, erectile dysfunction or visible blood in the urine.
Your report shows each result with the laboratory's reference range. PSA naturally rises with age as the prostate grows, so clinicians use age-specific thresholds. The thresholds used in NICE suspected-cancer referral guidance are: above 2.5 µg/L for ages 40 to 49, above 3.5 for 50 to 59, above 4.5 for 60 to 69 and above 6.5 for 70 to 79. Different PSA assays do not always give identical results, so it is best to compare results from the same laboratory over time.
Why PSA may be raised without cancer
- Benign prostate enlargement, which becomes common with age
- Prostate inflammation or a urinary infection
- Ejaculation, anal sex, vigorous exercise or cycling in the previous 48 hours
- Recent prostate examination, catheter, biopsy or surgery
- Testosterone treatment
Why PSA may be lower than expected
Medicines for prostate enlargement or hair loss such as finasteride and dutasteride can substantially lower PSA, and anti-androgen treatments lower it further. Tell your clinician if you take these, as results must be adjusted for them.
Limits of the test
A raised PSA does not mean you have cancer, and many men with a raised result do not. A normal result does not rule out prostate cancer, because some cancers do not raise PSA. The free/total ratio refines the probability but cannot say whether a cancer, if present, is slow-growing or likely to cause harm.
If your result is above the range for your age, we recommend discussing it with your GP, who may repeat the test. With your consent, Juvenology can write to your GP with your results. Please do not delay seeing your GP about symptoms because a private result was normal.
People often consider PSA testing because of age, ethnicity or a family history of prostate, breast or ovarian cancer. Testing has potential benefits and harms. It may find a significant cancer earlier in some men. It can also lead to anxiety, further tests such as MRI and biopsy, and the diagnosis and treatment of slow-growing cancers that would never have caused harm. Treatment for prostate cancer can affect continence and erections.
Before testing, it helps to think about what you would do with a raised result. Prostate Cancer UK provides an online risk checker that can help you prepare for a conversation with your GP. If you know you carry a BRCA2 variant, ask your GP or genetics team about the targeted NHS screening programme.
May be helpful for
- People with a prostate, typically aged 50 or over, who have considered the pros and cons and want a PSA result
- People with a family history of prostate, breast or ovarian cancer who want a result to discuss with their GP
- People whose clinician has asked for free PSA alongside total PSA
May not be the right test if
- You have urinary symptoms or blood in your urine: see your GP, who can examine you and arrange NHS tests
- You are already being monitored for a prostate condition: follow your specialist team's testing plan
- You have had a urinary infection, prostate biopsy or other prostate procedure recently: ask your clinician how long to wait
- You would not want further investigation whatever the result
- You cannot pass urine at all: this needs urgent medical attention (NHS 111 or A&E)
The prostate tends to enlarge with age, and PSA rises with it, which is why thresholds increase with age. Prostate cancer also becomes more common with age, but many cancers found by PSA testing in older men grow slowly. Test results for men with a limited life expectancy are less likely to lead to a benefit.
This test gives information about one gland at one point in time. It does not measure biological age, predict lifespan or reflect overall health.
- 48 hours before: avoid ejaculation, anal sex, vigorous exercise and cycling, as these can raise PSA.
- Urinary infection: if you have had one, wait until 4 to 6 weeks after it has cleared.
- Procedures: have the blood test before, not soon after, a prostate examination, catheter, biopsy or surgery, and ask your clinician how long to wait afterwards.
- Food and drink: you can eat and drink normally.
- Medicines: tell us if you take finasteride, dutasteride, testosterone or anti-androgen medicines. Do not stop any medicine to take the test.
- Biotin: tell us if you take high-dose biotin; the laboratory will advise whether to pause it.
Choose how your sample is taken when you book. We confirm the collection option, any collection fee and the expected turnaround time before you book.
- Juvenology Clinic, Maidstone (82 King Street, Maidstone ME14 1BH): Available.
- Partner collection location, including London: Available on request. We confirm availability for your postcode before you book.
- Postal home finger-prick kit: Ask before ordering. We offer a home kit only where the laboratory confirms this test is suitable for a finger-prick sample.
Sample: Venous blood sample (serum)
Collection notes: Avoid ejaculation, anal sex, vigorous exercise and cycling for 48 hours, and wait 4 to 6 weeks after a urinary infection has cleared. Free PSA is less stable than total PSA once blood is taken, so samples need prompt processing; a home finger-prick kit is offered only if the laboratory confirms its free PSA method is validated for posted samples.
The price of this test covers laboratory analysis and the laboratory's results report. The report lists each result beside the laboratory's reference range.
Beyond the blood test: optional support, priced separately
- Personalised written interpretation report: £50
- General consultation: £50
- Results consultation (results discussion and follow-up advice): £100
- Personalised programme: from £150, after we assess whether a programme suits you
Consultations are with Marina, an NMC-registered nurse with an Executive MSc in Longevity from the Geneva College of Longevity Science. She explains what your results show and how they relate to lifestyle. No prescription service is offered with these tests.
If a result suggests you need medical follow-up, we will recommend that you see your GP and, with your consent, can provide a letter to take with you. A blood test cannot rule out every condition. If you have symptoms, speak to your GP or NHS 111, and call 999 in an emergency.
Is this a prostate cancer screening test?
No. The UK National Screening Committee advises against screening all men because of the risk of overdiagnosis. This is an individual test for people who have made an informed choice.
What does the free/total PSA ratio add?
When total PSA is mildly raised, a lower proportion of free PSA is associated with a higher chance of cancer. It can help a clinician weigh up next steps, but in UK practice a persistently raised PSA usually leads to an MRI scan, which the ratio does not replace.
My PSA is raised. Does that mean I have cancer?
Not necessarily. Benign enlargement, infection, ejaculation or exercise can all raise PSA. Your GP will usually repeat the test and consider your age, examination and history.
My PSA is normal. Can I stop worrying?
A normal result is reassuring but does not completely rule out prostate cancer. If you develop urinary symptoms, blood in your urine or other new symptoms, see your GP whatever your previous result.
I take finasteride or testosterone. Will this affect my result?
Yes. Finasteride and dutasteride lower PSA substantially, and testosterone treatment can raise it. Tell us when booking and tell any clinician reading your result.
How often should I repeat the test?
There is no set schedule outside a screening or monitoring programme. If you repeat it, use the same laboratory and discuss the interval with your GP.
Is interpretation included in the price?
The price covers laboratory analysis and the laboratory's report, which shows each result with its reference range. You can add a personalised written interpretation report (£50) or book a results consultation (£100) with Marina, our NMC-registered nurse. Where a result needs medical attention, we will advise you to see your GP.
- PSA test. NHS website, reviewed 2024. https://www.nhs.uk/tests-and-treatments/psa-test/
- UK NSC recommends prostate cancer screening for men with a BRCA2 gene change and family history of cancer. Cancer Research UK News, 28 May 2026. https://news.cancerresearchuk.org/2026/05/28/uk-nsc-recommends-prostate-cancer-screening-for-men-with-a-brca2-gene-change-and-family-history-of-cancer/
- The UK NSC's prostate cancer screening model will remain open and under review. UK National Screening Committee blog, GOV.UK, 11 August 2026. https://nationalscreening.blog.gov.uk/2026/08/11/the-uk-nscs-prostate-cancer-screening-model-will-remain-open-and-under-review/
- PSA testing update in asymptomatic men. Prostate Cancer UK, 2026. https://prostatecanceruk.org/for-health-professionals/guidelines/psa-testing-update-in-asymptomatic-men
- Suspected cancer: recognition and referral (NG12). National Institute for Health and Care Excellence, 2015, last reviewed 2026. https://www.nice.org.uk/guidance/ng12
- Catalona WJ, Partin AW, Slawin KM, et al. Use of the percentage of free prostate-specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial. JAMA, 1998;279(19). https://doi.org/10.1001/jama.279.19.1542
- Prostate-Specific Antigen (PSA), Total and Free, Serum: test overview. Mayo Clinic Laboratories (accessed 2026). https://www.mayocliniclabs.com/test-catalog/overview/81944/prostate-specific-antigen-psa-total-and-free-serum
