PSA test – who pays the costs?

PSA determination is a procedure used in the early detection of prostate cancer. It is a complementary method whose analysis requires a high level of expertise and must be analyzed in connection with the other test results. If you are suspected of having prostate cancer, the doctor will explain the various examination procedures and explain the order in which they are used. This is important to avoid misinterpretations. It is important for you to know that in most cases this type of cancer grows very slowly.

While uncertainty can be troubling, the step-by-step approach to prostate cancer is important. It is also possible that the tumor does not continue to grow and only observation is required. All of this can be clarified by the investigations. Of course, you have the right to request further investigation procedures. However, if the doctor and health insurance company are convinced that this is not necessary, you will have to pay for the costs yourself.

Carrying out a PSA test

PSA determination is not the first procedure your doctor will suggest if you suspect prostate cancer. The doctor will first carry out a tactile examination. If the suspicion is confirmed, further investigations are prepared. This usually includes an ultrasound examination, followed by the PSA test.

A blood sample is required for the PSA determination. Your urologist will tell you what to look for beforehand. It is usually not necessary for you to remain sober during this examination. This also means that blood is not necessarily taken early in the morning. In order to reduce the influence on the values ​​as much as possible, your doctor will ask you to refrain from sexual activities and a sauna in the days before the examination. Some sports should also be avoided in this short time. When you bathe, the water should also not be too hot.

Results of the PSA determination and its interpretation

PSA is the abbreviation for the prostate-specific antigen. It is a protein that is formed by the tissue of the prostate and is therefore referred to as specific. Its job is to liquefy the semen after ejaculation. So it occurs naturally in a certain concentration in the body and is also detectable in the blood. How high the value is depends on the age of a healthy man. Apart from that, he can also differ from man to man. This is one of the reasons why the PSA determination alone is not enough to make a diagnosis. Overall, however, the value increases with age and can be twice as high in men over 70 years of age as in men with 40 years.

About 40 years ago, scientists found that the PSA value could provide evidence of a prostate tumor. The PSA value is used to support or invalidate the suspicion of prostate cancer. However, it can also be used for an already confirmed diagnosis and document the course of the cancer.

Possible sources of error in the PSA determination

If you also want the results of the tests to be handed over to you, you should know a little more about the values, particularly with regard to the PSA determination. A high value does not mean that you are safe from cancer. Likewise, a low value unfortunately does not guarantee that you are healthy. The results have to be seen in context. In addition, factors can be excluded that can change the values ​​without having anything to do with cancer. It can e.g. For example, it may be that your prostate has only enlarged and thus also produces more PSA. Increases in PSA levels can also be caused by:

  • Constipation (heavy pressing)
  • Sports with prostate problems (riding, cycling)
  • intercourse

In addition, some tests performed may be the cause of increased values, such as B. a tactile examination of the prostate, a urinary catheter, a biopsy or the reflection of the urethra. Conversely, there are also reasons for a low value that can hide the possibility of cancer. Above all, this includes medication. If you know your values ​​and are concerned about the results, ask your doctor how he sees them. However, answer all questions about lifestyle and medication truthfully so that your doctor can correctly assess the results.

Errors can also occur in other diagnoses related to early detection. That applies e.g. B. skin cancer. Suspicious skin areas are removed and examined in the laboratory, because this is the only way to distinguish harmless pigment spots from black skin cancer. In addition, precursors of white skin cancer are hardly recognized by the patients themselves. What looks like a rough spot can actually be a serious sign. It’s similar with prostate cancer. Problems with urination or sexual intercourse can have their cause here. Therefore, you should always inform your doctor if the signs are unclear, especially if the symptoms persist.

Health insurance covers the cost of the PSA test

From the age of 45, you have the right to have a urologist’s check-up once a year. However, the PSA determination is not part of such an investigation. This only includes the tactile examination, the examination of the genitals and the palpation of the lymph nodes in the groin area. This right is regulated by law. For this reason, every health insurance company pays the costs. If there are any abnormalities and a possible diagnosis needs to be secured, the health insurance company also assumes the costs for the PSA determination. The decisive factor is whether the doctor considers it necessary. There are health insurance companies that reimburse the costs of the examination even if only you want the PSA determination. Since this is a voluntary service,


Doctors are bound by the fee schedule (GOÄ). As part of the fee schedule, you can set the fees for examinations and treatments. A PSA exam is not expensive. Expect an invoice in the amount of 50 to about 100 euros. In any case, clarify this in advance with the doctor himself.

Take advantage of the free check-ups and tell your doctor if you experience symptoms that suggest problems with the prostate.


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