Should I have a PSA test, and when is a prostate MRI needed?

Men aged 50 and over can choose a PSA blood test after discussing the benefits and limits with a doctor. In May 2026, the UK National Screening Committee recommended screening only for men aged 45 to 61 with a BRCA2 gene change and a family history of cancer. A raised PSA is usually followed by a prostate MRI before any biopsy.

Key points

• On 28 May 2026, the UK National Screening Committee recommended against screening all men for prostate cancer and in favour of targeted PSA testing every two years for a small, high-risk group.

• Around 8 in 10 men with a raised PSA result do not have prostate cancer, according to Cancer Research UK.

• Prostate MRI before biopsy found clinically significant cancer far more accurately than standard biopsy in the PROMIS trial, with 93% sensitivity against 48%.

• In the PRECISION trial, MRI-first testing found more significant cancers and let 28% of men avoid a biopsy altogether.

• The Online GP by The Wellness offers doctor-led PSA testing and arranges prostate MRI with a consultant radiologist report, with fees confirmed on WhatsApp.

What did the 2026 prostate screening decision say?

The UK National Screening Committee published its final recommendation on 28 May 2026. It advised against screening all men for prostate cancer, because the PSA test is not reliable enough at population level. It recommended targeted PSA testing every two years for men aged 45 to 61 with a BRCA2 gene change and a family history of breast, ovarian, pancreatic or prostate cancer.
The UK NSC published the minutes of its decision in May 2026. The committee concluded that screening all men, or men with a family history but no BRCA2 change, was more likely to cause harm than good. It described ongoing uncertainty for Black men.
The UK government accepted the recommendation in June 2026, according to Cancer Research UK. Prostate cancer charities said the decision left out many men at higher risk.

Can I still have a PSA test if I am not in the screening group?

Yes. Men aged 50 and over can ask for a PSA test after a conversation with a doctor about its benefits and limitations. Men at higher risk, including Black men and those with a father or brother diagnosed with prostate cancer, may reasonably discuss testing from 45.
A PSA test measures a protein made by the prostate. Levels rise with prostate cancer, but also with an enlarged prostate, infection, recent ejaculation and vigorous cycling. That is why a single result needs careful interpretation.
Cancer Research UK reports that around 8 in 10 men with a raised PSA do not have prostate cancer. Some men with prostate cancer have a normal PSA. Ask a doctor on WhatsApp whether a PSA test suits you.

Why is a prostate MRI done before a biopsy?

A prostate MRI is done before a biopsy because it shows whether there is an area worth sampling and where it is. This finds significant cancers more accurately, targets the biopsy needle precisely, and lets many men with a normal MRI avoid a biopsy altogether. MRI-first is now standard practice in the UK.
The PROMIS trial, published in The Lancet in 2017, found multiparametric MRI detected clinically significant prostate cancer with 93% sensitivity, compared with 48% for standard ultrasound-guided biopsy. The researchers estimated that 27% of men could avoid a first biopsy.
The PRECISION trial, published in the New England Journal of Medicine in 2018, found MRI-targeted biopsy detected clinically significant cancer in 38% of men, compared with 26% using standard biopsy. Around 28% of men in the MRI group avoided biopsy because their scan was normal.

What happens if my PSA is raised?

If your PSA is raised, the doctor first checks for simple causes such as infection, and usually repeats the test after a few weeks. If it stays raised, the next step is a prostate MRI. The doctor writes the referral, a consultant radiologist reports the images, and the doctor explains the result and the plan.
"A raised PSA is a question, not a diagnosis," says Dr Adel Elalfy, Head of Primary Care at The Online GP by The Wellness. "The MRI usually answers it within days, and most men leave with reassurance rather than a biopsy."
If the MRI shows a suspicious area, the doctor refers you to a urologist for a targeted biopsy and specialist care. Discuss a raised PSA with a doctor on WhatsApp.

Who is at higher risk of prostate cancer?

Men at higher risk of prostate cancer include those over 50, Black men, men with a father or brother diagnosed with prostate cancer, and men with BRCA2 or other inherited gene changes. Black men in the UK have about a 1 in 4 lifetime risk of prostate cancer, compared with about 1 in 8 for all men, according to Prostate Cancer UK.
Family history of breast or ovarian cancer on either side of the family can also signal an inherited gene change. Tell the doctor about any cancers in close relatives.

How much does a PSA test and prostate MRI cost?

Extended in-person private GP visits in major UK cities can reach £250 or more, according to a 2026 cost guide from Doctor Care Anywhere. At The Online GP by The Wellness, a classic GP appointment to discuss testing starts from £150.
PSA tests and prostate MRI are quoted per patient from the clinic's partner list, and the team confirms fees on WhatsApp before booking. For a wider assessment, the Executive Physical starts from £2,995. Ask about PSA and prostate MRI fees on WhatsApp.

Can a doctor tell me if I need a PSA test?

Yes. The Online GP by The Wellness offers a free suitability review. Send your age, family history, any urinary symptoms and previous PSA results on WhatsApp. A doctor either recommends testing or tells you plainly that waiting is the better choice for now.
Start your free suitability review on WhatsApp.

Frequently asked questions

What can make a PSA result high without cancer?

An enlarged prostate, a urinary infection, recent ejaculation, vigorous exercise such as cycling, and some medical procedures can all raise PSA. The doctor advises how to prepare before the test.

Does a prostate MRI hurt?

No. A prostate MRI is painless. You lie still in the scanner for around 30 to 45 minutes, and some scans include an injection of contrast dye.

Is a normal PSA a guarantee I do not have prostate cancer?

No. Some men with prostate cancer have a normal PSA. Report urinary symptoms or family history to the doctor even if a previous result was normal.

Can I have a prostate MRI without a raised PSA?

A doctor may recommend a prostate MRI for men at high risk, such as those with a BRCA2 gene change, or when an examination finds an abnormal prostate. The doctor decides based on your history.

Sources

• UK National Screening Committee, minutes and final prostate cancer screening recommendation, May 2026

• Cancer Research UK, UK NSC recommends targeted prostate cancer screening, May 2026

• Ahmed HU and colleagues, PROMIS trial, The Lancet, 2017

• Kasivisvanathan V and colleagues, PRECISION trial, New England Journal of Medicine, 2018

• Prostate Cancer UK, prostate cancer risk statistics

• Doctor Care Anywhere, Private GP appointment cost UK, 2026
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