2 days ago
The £12 at-home prostate cancer test that could save you weeks of waiting for a GP
It's a slightly odd moment when I fire the little spring-loaded lancet into my own hand and, despite my attempts to bleed neatly, the kitchen table takes on a crime-scene feel. I've waited until family members are out and I'm able to process results alone, decide on next steps, and set my face if needed.
I'm taking a prostate health blood test that I bought in Sainsbury's. It uses the little white plastic result tray familiar from Covid, capturing a drop of blood. The makers of the test I'm using say take up has increased 69 per cent since launch, two years ago. More and more of us are checking ourselves in this way, but what does it entail and what do you need to know?
There is something satisfying about taking some control of your own health, and that's how it feels to take a prostate health test in your kitchen. It requires some self-education and a little caution, but I'm a fan. There are two kinds currently available – the pin-prick quick response that I am trying, and those that require a larger sample to be sent to a lab. Other commercial screenings exist, but have not been rolled out for home use yet.
The commercial laboratory tests are much the same as an NHS blood test, only without the doctor to interpret results and place them in context (many provide this as an optional extra). Both measure PSA, a naturally occurring protein that can be an indicator of cancer.
Testing at home for medical conditions is a booming business, with the global at-home medical testing market estimated at $7.4 million (£5.5m) in 2024.
I have to confess, the idea of peering into my health in the privacy of my own home is very appealing – especially while there is no national screening programme. The faff of arranging appointments, the vulnerable feeling that overtakes you as you walk through the door of the surgery, and the worry about managing feelings: all of this makes lightly stabbing myself at the kitchen table feel more than worth it.
Pros of self-test kits
They are (reasonably) accurate
Nick James, professor of prostate and bladder cancer research at the Institute of Cancer Research, and the Royal Marsden Hospital in London says, 'We did a bit of research on tests of this type and they weren't bad, to be honest. We dual-tested 50-100 [patients], comparing our lab results with their results – there was some inaccuracy at the borderline between normal and abnormal, but did that matter? Probably not. Once you have a properly abnormal PSA they will be accurate'.
They are quick
Prof James says: 'It is quite a good way of circumventing the initial chat with the GP. Most things in life you have control of, you want a pizza you pick up the phone and it arrives. It's only in medicine where you have to be grateful for what the NHS gives you, which might be great or it might be rubbish.'
They are a useful start
'There's not much you can do wrong with them really,' says Prof James. 'If you have the test and it's normal, probably the NHS test would be normal too, if it's abnormal that should allow you to drive a referral. I tried to get an NHS PSA just to see the process, and it took me weeks and weeks.'
They are cheap and easy
Frederick Manduca is a director of Newfoundland Diagnostics, which makes the lateral flow PSA test I used. He says: 'There's a convenience factor, you can buy the test in Sainsbury's with your shopping and the result is there within ten minutes. It retails at £12, so you can screen regularly. It's easy to use. You only need a few droplets of blood and you can put it through the lateral flow test.'
They are set up for the most at-risk group
Newfoundland tests record any PSA score up to four as normal. 'We chose four as the dividing line,' says Manduca. 'It's all based on what we see as the most helpful cut-off for age. If we were screening 20-40 year olds the cut off would be much lower, but because that group is at such low risk, we weren't focused on them. At 70-plus, an abnormal result comes in between 4 and 5 PSA, between 50 and 70, anything from 4.00 upwards is definitely raised. It's the mid-point for that age range.'
Cons of self-test kits
Interpreting the results
It's about self-education. PSA is not a cancer indicator in itself. Manduca says: 'The key is people understanding when they should test and what the results mean – this is a test for a protein the body produces, it's not a test for prostate cancer.' The Newfoundland tests come with a leaflet produced in conjunction with a cancer charity.
How do the self-test kits compare to a clinical screening?
There has been some controversy about this. A BBC report into the rapid response tests (no brands were specified) said: 'Of the five kits analysed by the BBC, one did not produce a readable result; three came back all clear; but one did show a solid dark line, indicating a PSA level above 4.0 ug/l. A private blood test taken the same day and sent to a laboratory, showed a much lower reading of 0.27 ug/l.'
Manduca says the Newfoundland kits are tested against approved independent lab results: '92 per cent of the time the lab tests and the rapid tests were agreeing. There are slight deviations and cut-offs, if you were right on a boundary number, say 3.9.'
He warns, however, that there are less reliable tests sold online and consumers need to check for official approvals before buying.
The Prostate Cancer UK site says: 'We recommend that if you're worried about prostate cancer and want a PSA blood test, you should speak to your GP. It's crucial that, before you have a PSA blood test, you get balanced information or counselling from a healthcare professional, and that you get professional follow-up about your result and what to do next.'
How to read your self-test kit results
Any PSA is far from conclusive. Using a cheap and reasonably accurate home test can allow you to track your number and spot any changes. An NHS PSA test is also not definitive, and a high number should mark the start of an investigation. Figures for 'normal' PSA scores by age are available online, but any worries need full investigation with MRI scans via the doctor.
Fredrick Manduca says: 'It's a tool in an overall toolkit. A lot of men don't know that if do they have a raised PSA only one-in-four of them will have prostate cancer. The general concept is for someone to test every year or every two years depending on how at risk they are, and see if there's a change.'
My test, by the way, was normal, matching my most recent PSA which came in under 4.00. But I shall continue to monitor myself, looking for tell-tale changes.
