Prostate Cancer

Causes & Risk Factors

Prostate cancer risk is influenced by a combination of largely non-modifiable factors:

•  Age — risk increases significantly with age, particularly after 50.

•  Family history — having a first-degree relative (father or brother) with prostate cancer roughly doubles individual risk.

•  Inherited genetic variants — certain hereditary variants, including BRCA2 and other genes associated with hereditary cancer syndromes, increase risk and may be associated with more aggressive disease.

•  Ethnicity — prostate cancer incidence and severity vary by population group, based on epidemiological data.

•  Diet — some studies suggest a diet high in certain fats may be associated with modestly increased risk, though evidence is less definitive than for other risk factors.

Symptoms & When to Test

Early prostate cancer frequently causes no symptoms at all, which is why PSA-based screening (where appropriate for the individual, as advised by a doctor) plays an important role in early detection.

•  Often asymptomatic in early stages, detected through PSA testing or examination

•  Urinary symptoms — increased frequency, weak or interrupted stream, difficulty starting urination (more often due to benign prostate enlargement, but warranting evaluation)

•  Blood in urine or semen (less common, warrants prompt evaluation)

•  Bone pain, in advanced disease with bone involvement

•  Erectile dysfunction, in some cases

When Should You Consider Testing?

PSA testing is generally discussed with a doctor from around age 50 (or earlier with a family history or other risk factors), as part of an informed decision about screening. New urinary symptoms, blood in urine or semen, or unexplained bone pain should prompt medical evaluation regardless of screening status.

Why Tests Are Combined

PSA is a useful initial screening and monitoring tool, but it can be elevated for reasons unrelated to cancer (such as benign prostate enlargement or infection), which is why an elevated PSA typically leads to further evaluation — including histopathology from a biopsy — rather than being treated as diagnostic on its own.

In patients with confirmed prostate cancer, particularly advanced disease, molecular and genetic testing may be added to identify targetable alterations or to assess hereditary risk, since a subset of prostate cancers carry genetic features (including BRCA2 and related genes) that can influence both treatment selection and family risk counselling.

The combination of PSA monitoring, histopathological grading, and selected molecular testing allows for a more individualized approach to both diagnosis and treatment planning than any single test alone.

Tests Available at NPL

Most tumor molecular tests, histopathology, IHC, and genetic tests do not require fasting. However, some blood-based investigations ordered alongside cancer testing may have specific preparation requirements. Please follow the instructions provided by your doctor or NPL.

Home Sample Collection

PSA blood testing can be arranged through NPL's standard home sample collection service.

Prostate biopsy — required to confirm a cancer diagnosis after an abnormal PSA or examination finding — must be performed by a urologist at a clinic or hospital, and is not a home collection service.

Once your biopsy sample is obtained, NPL arranges secure transport of the tissue to our accredited laboratory for histopathology and, where indicated, molecular testing.

Germline genetic testing for hereditary risk is blood-based and can typically be arranged via home collection — confirm with your care team.

When to See a doctor

•  New or worsening urinary symptoms (frequency, weak stream, difficulty starting)

•  Blood in urine or semen

•  Unexplained bone pain, particularly with a known prostate condition

•  Family history of prostate, breast, ovarian, or pancreatic cancer — discuss screening timing with your doctor

•  An elevated PSA result requiring further evaluation