PSA Test Risks: What You Need to Know Before Getting Screened

When you hear PSA test, a blood test that measures prostate-specific antigen levels to screen for prostate cancer. Also known as prostate-specific antigen test, it's one of the most common screenings for men over 50. But a high result doesn't mean you have cancer — and that’s where the real problems start. Many men get scared when their PSA number goes up, only to find out later it was just inflammation, an enlarged prostate, or even a recent bike ride. The test doesn’t diagnose cancer — it just flags that something might be off. That’s why understanding the false positives, when the PSA test shows elevated levels but no cancer is present is just as important as knowing what a normal reading looks like.

The biggest risk isn’t the blood draw — it’s what happens after. A high PSA often leads to a prostate biopsy, an invasive procedure where tissue samples are taken from the prostate to check for cancer. That procedure carries its own risks: infection, bleeding, pain, and even hospitalization in rare cases. And here’s the twist — many of those biopsies find slow-growing cancers that would never harm you. Yet once diagnosed, men often feel pressured to start treatment — surgery, radiation, hormone therapy — with side effects like incontinence, erectile dysfunction, and fatigue. That’s overtreatment, and it’s more common than you think. The PSA levels, the numerical value measured in nanograms per milliliter that indicates prostate activity can swing for all kinds of reasons — infection, ejaculation, cycling, or even a digital rectal exam the day before. One high number doesn’t tell the full story.

So what’s the right move? It’s not about avoiding the test entirely — it’s about knowing what you’re signing up for. Talk to your doctor before you get tested. Ask: What happens if my PSA is high? What are the chances it’s not cancer? What are the risks of a biopsy? And if cancer is found, is it aggressive or slow-growing? Some men benefit from early detection, especially those with a family history or Black men, who face higher risks. But for others, the risks of screening outweigh the benefits. The goal isn’t to scare you — it’s to help you make a choice based on facts, not fear. Below, you’ll find real-world insights from men who’ve been through this, studies that show what actually works, and clear breakdowns of alternatives to the standard PSA test. You’re not alone in this. And you don’t have to rush into anything.