Structured screening · Urology · London
Private prostate screening, structured PSA-led screening for men over 50, or 45 if higher risk.
Structured private prostate cancer screening — age-adjusted PSA testing, symptom review, family history stratification and pathway into mpMRI where clinically indicated. Follows NICE and international best practice.
Why patients choose us
- 01
Structured, not ad-hoc
Age-adjusted PSA, symptom review, family and BRCA history — assessed together, not in isolation, so the answer means something.
- 02
Direct mpMRI pathway
When PSA or examination raises a flag, a consultant uroradiologist mpMRI slot is arranged — no restart, no repeat referral.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
Six things worth knowing before you book.
A structured screen is defined more by how it’s interpreted than by any one measurement.
In short
Screening starts from age 50 — or from age 45 if you carry higher risk.
-
Definition
Structured PSA-led prostate cancer screening — clinical, laboratory and imaging pathway.
-
From age 50
Or from age 45 if higher risk — family history, BRCA carrier, or Black-Caribbean / Black-African ethnicity.
-
Age-adjusted PSA
The threshold shifts with age — a single cut-off across decades misses cancers and over-diagnoses.
-
Family + BRCA history assessed
First-degree relatives, Lynch and BRCA1/2 status materially change screening intensity.
-
Direct pathway into mpMRI + biopsy
A rising PSA or suspicious finding routes straight to multiparametric MRI, and targeted biopsy where indicated.
-
Annual review cadence
Screening is a series, not a single test — an annual review lets the PSA trend, not one number, drive decisions.
The problem
An unstructured PSA on its own can mislead in both directions.
A single PSA number — read without age-adjusted thresholds, DRE, family history and BRCA status — can miss significant cancer or drive unnecessary biopsy. A structured screen answers a better question.
-
Over 50, no formal screen?
We start with an age-adjusted PSA, DRE and family history — a proper baseline you can build on.
-
Family history or BRCA carrier?
Screening from 45 with a tighter cadence — and a documented plan for annual review.
-
Rising PSA on a prior test?
We put a trend line through the numbers and, if needed, arrange mpMRI without a restart.
The pathway
From consultation to annual review — what happens, in order.
One clinician frames the screen, holds the results, and owns your annual review.
Phase 1 · Before your visit
Concierge, off-stage for you
Phase 2 · At the clinic
History, DRE and risk stratification
Phase 3 · After
Imaging pathway and annual review
- 01
Before
Urology / GP consultation
A private urologist or GP with a specialist interest takes the history, examines you, and frames the screen.
- 02
Before
Personal and family history
First-degree relatives, ethnicity, prior PSA values, lower urinary tract symptoms and any prior prostate imaging.
- 03
Before
Age-adjusted PSA
A serum PSA interpreted against the age-adjusted threshold — not a single fixed cut-off — with velocity from any prior values.
- 04
At the clinic
Digital rectal examination
A short DRE by the consultant to assess prostate size, symmetry and any suspicious nodule.
- 05
At the clinic
Risk stratification
Age, ethnicity, BRCA / Lynch status and family history combined with PSA to place you in a risk band.
- 06
After
mpMRI pathway if indicated
A raised or rising PSA, PSA density concern or suspicious DRE triggers a multiparametric MRI slot — often within days.
- 07
After
Structured annual review
Result letter, agreed threshold for concern, and an annual review calendar — screening lives as a series, not one visit.
Typical baseline visit to written plan: 1–2 weeks. Urgent cases: same week.
What it shows
What a structured prostate screen actually surfaces.
The value is in the pattern — trend, density, examination and risk — not any one measurement in isolation.
-
Age-adjusted PSA trend
The direction of travel across visits, not a single number, is the strongest signal.
-
Family / BRCA risk category
BRCA1/2 carriers, Lynch families and first-degree relatives sit in a higher screening intensity band.
-
Suspicious DRE finding
A palpable nodule or asymmetry warrants mpMRI regardless of PSA.
-
PSA density
PSA relative to prostate volume — a more specific signal than PSA alone, especially with a large gland.
-
Prostate volume
Measured on mpMRI or ultrasound to interpret PSA density and to plan any targeted biopsy.
-
High-risk ethnicity flag
Black-Caribbean and Black-African men carry higher lifetime risk and are screened from age 45.
-
Symptom flag
Nocturia, hesitancy, poor stream or perineal pain are assessed in the same visit and documented alongside PSA.
-
Red flag: rising PSA + suspicious DRE — urgent mpMRI
A rising PSA together with an abnormal DRE is an urgent mpMRI, not a routine one — arranged the same week.
Options after screening
Where the screen leads next.
Screening isn’t treatment — but it opens doors. These are the pathways a structured screen can point toward.
-
Watchful waiting
For very low-risk profiles — a documented plan of observation without immediate imaging or biopsy.
-
PSA density monitoring
Serial PSA density measurements to separate benign enlargement from clinically significant disease.
-
mpMRI prostate
Multiparametric MRI reported to PI-RADS by a consultant uroradiologist — the modern gateway to biopsy.
-
Targeted biopsy
MRI-directed transperineal biopsy of PI-RADS 3–5 lesions, not blind sextant sampling.
-
Active surveillance
Structured monitoring of confirmed low-risk cancer with PSA, mpMRI and biopsy at defined intervals.
-
Structured urology follow-up
Named consultant, agreed cadence, and a written plan you and your GP can act on.
-
Genetic counselling (BRCA / Lynch)
Referral for germline testing and family counselling when the pedigree or age at diagnosis warrants it.
-
Multi-disciplinary team review
Complex or borderline findings are taken to a urology MDT — urologist, oncologist and radiologist together.
Our vetted London network
A small panel of clinicians, we picked them.
Consultant urologists and uroradiologists across central, north, west and south London. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinician in our network.
-
Consultant urologists with a prostate cancer subspecialty
-
Consultant uroradiologists reporting mpMRI to PI-RADS
-
Age-adjusted PSA thresholds, not a single fixed cut-off
-
Direct MRI-targeted transperineal biopsy pathway when indicated
Red flags
When a screen becomes an urgent pathway.
Most screens are routine. These features move the pathway forward — mpMRI within days, urology review the same week, or urgent uro-oncology input.
-
Rising PSA + suspicious DRE
Together, these warrant urgent mpMRI within days, not routine review.
-
BRCA1/2 carrier
Germline BRCA carriers are screened earlier and more intensively — annual PSA and clinical review from age 40.
-
Lynch syndrome family
Lynch pedigrees raise prostate cancer risk and trigger earlier, structured screening.
-
Black-Caribbean / Black-African ethnicity + PSA rise
Higher lifetime risk plus a rising PSA warrants a lower threshold for mpMRI.
-
Family history first-degree relative
A father or brother with prostate cancer — especially under 60 — lowers the age at which screening starts.
-
Post-radiotherapy rising PSA
A PSA rise after radiotherapy needs urgent uro-oncology review — biochemical recurrence pathway.
-
Post-prostatectomy PSA rise
Any detectable PSA after radical prostatectomy is biochemical recurrence and warrants urgent review.
-
Bone pain with elevated PSA
New skeletal pain in a man with elevated PSA is a red flag for metastatic disease — urgent imaging.
-
Haematuria with elevated PSA
Visible blood in the urine alongside a raised PSA requires urgent urological assessment.
Reading your report
A prostate screening letter can look technical. It isn’t.
Whatever the finding, the letter keeps to the same four parts.
A quiet reminder
The letter is written for your GP, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Age, risk factors and history
Your details, ethnicity, family and BRCA history, and any relevant symptoms — the frame for interpretation.
- 02 Findings
PSA, PSA density and DRE
The measured PSA against the age-adjusted threshold, PSA density if volume is known, and the DRE finding.
- 03 Imaging
mpMRI PI-RADS score, if performed
A multiparametric MRI reported to PI-RADS 1–5, with lesion location, size and likelihood of clinically significant cancer.
- 04 Impression
The plan: read this first
Risk band, whether imaging or biopsy is next, and the annual-review date — read this first.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about private prostate screening.
Quick answers on age, age-adjusted PSA, DRE, mpMRI, biopsy and how often to repeat the screen.
-
Who should have private prostate screening?
Structured private prostate screening is aimed at men from age 50, or from age 45 if higher risk — a first-degree relative with prostate cancer, a BRCA1 or BRCA2 mutation, a Lynch syndrome family, or Black-Caribbean / Black-African ethnicity. Screening is a series of annual reviews, not a one-off test.
-
What is age-adjusted PSA?
The PSA threshold that flags concern shifts with age — a 3.0 ng/mL result means something different at 45 than at 75. Age-adjusted screening uses banded thresholds rather than one fixed cut-off, which reduces both missed cancers and over-diagnosis.
-
Do I need a digital rectal examination?
Yes — a short DRE by the consultant is part of the structured screen. It picks up palpable abnormalities that PSA alone can miss, and a suspicious DRE routes you into mpMRI regardless of the PSA number.
-
What is mpMRI and when is it done?
Multiparametric MRI is the modern imaging test for the prostate, reported to a five-point PI-RADS scale by a consultant uroradiologist. It is done when age-adjusted PSA, PSA density, DRE or risk profile raise concern — and it precedes biopsy, so blind sampling is avoided.
-
Is a biopsy always needed after mpMRI?
No. PI-RADS 1–2 lesions typically do not need biopsy and are followed up. PI-RADS 3–5 lesions usually warrant an MRI-targeted transperineal biopsy — a targeted sample of the suspicious area, not a blind survey of the whole gland.
-
How often should I have private prostate screening?
Annually for most men in the screening age band, with the cadence tightened for BRCA carriers, Lynch families and first-degree relatives of men diagnosed young. The annual review lets the PSA trend, not a single value, drive decisions.
Sources
Guidelines this guide follows.
- NICE. Prostate cancer: diagnosis and management (NG131).
- European Association of Urology. Guidelines on prostate cancer.
- American Urological Association. Early detection of prostate cancer guideline.
- Prostate Cancer UK. Information and support.
Published 2026-07-30 · Next review 2027-07-30 · Reviewed by Pulse Atlas Editorial Board, .
Related tests
Looking for a different test?
-
PSA prostate check
The stand-alone PSA blood test — what it is and how it’s used.
Learn more -
Private prostate health check
A broader prostate health assessment beyond screening alone.
Learn more -
Prostate biopsy
MRI-targeted transperineal biopsy — how it’s done, and when.
Learn more -
All tests
Browse every test and procedure we arrange.
Learn more -
Prostate Enlargement BPH
Related condition guide.
Learn more -
Kidney Disease CKD
Related condition guide.
Learn more -
Cystectomy
Related treatment option.
Learn more -
Cystoplasty
Related treatment option.
Learn more
In practice, in London
Booking private prostate screening privately in London — what actually happens
With private prostate screening, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. The wait for private prostate screening on the NHS depends heavily on where you live and how urgently the referral is graded. Central and West London private clinics can normally book within a week, with imaging or a procedure slot to follow shortly after. It’s worth being honest about the reason for going private: usually it’s time, not a fundamentally different test.
Once you’re in the private system for private prostate screening, the pace picks up noticeably. Consultant slots run to time, imaging is usually available in the same building or a short walk away, and the report comes back typed and detailed. It’s the coordination that tends to feel different — one person on the other end of the phone, not a switchboard. For private prostate screening specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
The value of going through a concierge for private prostate screening isn’t access — anyone with an insurer or a credit card can get a private appointment in London. The value is knowing which consultant reads this particular presentation best, which unit turns reports around fastest, and which pathway won’t hit a dead end if the findings point somewhere unexpected.