Why We Do Not Flag PSA Results for Men Under 40

If your PSA result is in your report but not flagged, you have probably noticed. Here is the reason for that decision, and what it means for you.

PSA is a protein made by the prostate gland (prostate-specific antigen). Measuring the amount in your blood is one way to check on prostate health. A raised level can be linked to prostate cancer, but it can just as easily come from other, harmless causes. These include an enlarged prostate, infection or inflammation, hard exercise, or recent sexual activity.

We measure PSA as part of some of our health assessments. If you are 40 or over, we flag your result in the usual way if it falls outside the range expected for your age. If you are under 40, we still record your result, but we do not flag it in the same way. This is a deliberate decision, based on the clinical evidence, and this article explains why.

Why age matters so much for PSA results

Prostate cancer mainly affects older men. It is rare before age 50, and most cases that matter clinically happen in men over 60. In the UK, the most common age for diagnosis is around 70 to 74.

In younger men, PSA levels are naturally low, but they also vary a lot from person to person, even when nothing is wrong. A result that would be a concern in a 65-year-old could be completely normal for a 35-year-old. This is why PSA ranges are adjusted for age (reference ranges). What counts as raised changes a great deal as you get older.

For men under 40, the risk of prostate cancer is very low. Flagging results in this age group is more likely to cause unnecessary worry and unnecessary follow-up tests than to catch a genuine problem. The evidence does not support flagging PSA results routinely below the age of 40.

PSA testing is not straightforward, even in older men

Unlike some tests, a raised PSA result does not reliably point to disease. It is a fairly non-specific marker, meaning it can be raised for many reasons that have nothing to do with cancer, and not every prostate cancer raises PSA. Because of this, results need careful interpretation at any age.

The NHS does not currently offer PSA screening to all men as routine. If you are 50 or over and want a PSA test, you can ask your GP for one. This falls under the NHS Prostate Cancer Risk Management Programme, which makes sure you get clear information about what the test can and cannot tell you, before you decide whether to go ahead.

If you have a strong family history of prostate cancer, see the section below on how we can take this into account in your assessment.

What about men under 40 with a family history of prostate cancer?

This is an important exception. If you are under 40 and have a strong family history of prostate cancer, for example a father or brother diagnosed at a younger age, this changes things. You can request a PSA test as part of your Bluecrest assessment, and your result will then be interpreted and flagged in a way that fits your personal risk.

A strong family history meaningfully changes your risk. We recognise that for this group, earlier awareness and monitoring is clinically worthwhile. If this applies to you and you did not mention your family history at your assessment, contact our customer service team. They can advise you on next steps.

What this means for your result

If you are under 40 and do not have a relevant family history, your PSA result is still recorded. You can see it in your report. It simply does not carry a flag in the usual way, because the evidence does not support using age-based ranges for this group in a way that would be meaningful or useful.

If you have any concerns about your PSA result, at any age, take it to a GP. They can review it alongside your full medical and family history. That is where any further conversation about prostate health belongs.

For men aged 40 and over, we apply age-appropriate ranges and flag results in the normal way. A flagged PSA does not mean you have prostate cancer. It means the result is worth discussing with a GP, who can advise whether any further tests are needed.

This article is for general health information purposes and does not constitute medical advice. If you have concerns about your PSA result or prostate health, please speak with a healthcare professional.