General practitioner examinations and investigations should include testing PSA levels and evaluating the levels with reference to the effects of age on the normal range.

The significance of a rising PSA in a patient, even if the levels are within the age-adjusted normal range, should be recognised, as well as a PSA that is at the high end of the normal range in younger men. Measuring the free-to-total PSA ratio may be helpful in assessing the clinical significance of an elevated PSA. Some high-risk prostate cancers do not produce much PSA and therefore in symptomatic men a digital rectal examination (DRE) should also be conducted, even if the PSA is in the normal range.

An abnormal PSA result should be discussed with the patient face to face and information (including the significance of an abnormal result and the steps in evaluation) provided.

In asymptomatic men with an elevated PSA, total PSA as well as free-to-total ratio should be assessed one to three months after the initial abnormal test. It is recommended that, in addition, all patients should undergo a midstream urine test (to check for prostatitis).