PSA test & screening
Detecting prostate cancer early

Why screening?

Early prostate cancer causes no symptoms. Waiting for symptoms to appear gives away the best chance of cure. Screening aims to find tumours that need treatment while they are still confined to the prostate – and to avoid treating harmless findings unnecessarily.

The PSA test measures prostate-specific antigen in the blood. A raised value is a clue, not proof: benign enlargement, inflammation or cycling the day before can raise it too. The value is most useful as a trend and in combination with MRI and clinical judgement.

The Austrian Society of Urology recommends a check-up for men from age 45 – from 40 if there is prostate cancer in the family or a known BRCA mutation.

What the check-up involves

The check-up takes about 30 minutes and is painless. After a conversation about symptoms, family history and previous results, we take blood for the PSA test, perform the digital rectal examination and an ultrasound of prostate, bladder and kidneys. I discuss the result with you – including how soon the next check makes sense.

History: symptoms, family, risk factors PSA measurement, free PSA and PSA density if needed Digital rectal examination of the prostate Ultrasound of prostate, bladder, residual urine and kidneys Urinalysis On request: testicular ultrasound and testosterone (men's health)
About men's health

What happens if the PSA is raised?

01.
Repeat and interpret

A first raised value is repeated after a few weeks, once inflammation has been excluded. PSA density, trend and age all feed into the risk assessment – not a single number.

02.
Multiparametric MRI

If the value stays suspicious, an MRI of the prostate is the next step. It shows suspicious areas and helps avoid unnecessary biopsies: with a normal MRI and low risk, monitoring can usually continue.

03.
Targeted fusion biopsy

A tissue sample is only needed with a suspicious MRI or a high-risk profile. The MRI images are overlaid on the ultrasound so that the suspicious area is sampled precisely with few cores.

04.
Discussing the result

If cancer is found, I explain the risk group and your options – from active surveillance to surgery.

More about prostate cancer

Frequently asked questions

What PSA level is concerning?

There is no fixed threshold. A value above 3–4 ng/ml is generally considered worth investigating, but age, prostate size, trend and MRI findings are decisive. Low values do not completely exclude cancer either.

How often should I be screened?

Depending on your baseline, every one to four years. With a very low PSA at 45, longer intervals suffice; with higher risk I recommend annual checks.

Do I need to prepare for the PSA test?

Avoid cycling and ejaculation for 48 hours before the blood test and make sure you have no acute bladder infection. You do not need to be fasting.

Is screening useful without symptoms?

Especially then. The check-up is aimed at men without symptoms – prostate cancer usually causes symptoms only at a late stage.

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