guidelines

prostate cancer referral

nice ng131: age-specific psa thresholds and dre findings for 2ww referral.

last reviewed: 2026-02-13
based on: NICE NG131
reviewer: Dr Kola Tytler MBBS CertHE MBA MRCGP
view official NICE source

2WW Referral Criteria

  • DRE: Prostate feels hard, irregular, or nodular.
  • PSA Levels:
    • 40–49y: >2.5 ng/ml
    • 50–59y: >3.5 ng/ml
    • 60–69y: >4.5 ng/ml
    • 70+y: >6.5 ng/ml

Testing Protocol

  • Timing: Avoid PSA testing within 48h of ejaculation, 1 week of DRE, or 6 weeks of proven UTI/prostatitis.
  • Counseling: Discuss the risk of false positives and potential for over-diagnosis before proceeding with PSA.

Transparency

This page is an educational, clinician-written summary of publicly available NICE guidance intended for trained healthcare professionals. It uses original wording (not copied text) and should be used alongside the full NICE source, local pathways, and clinical judgement. Doses provided are for general reference; always check the BNF/SPC.