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PSA test is non-specific (acute retention/catheterisation, BPH/TURP, old age, prostatitis, ca)
1 in 5  with normal PSA will have ca, 
2 in 3 with raised PSA will not have ca
All significantly raised PSA needs Bx
No evidence that early detection prolongs life
no distinction between aggressive tumours and slow growing ones that wouldn't otherwise be found

Best for high risk men (>70, black, FH)

Before test - 
no UTI
no ejaculation within 48 hrs
no PR in 1/52
no Bx in 6/52

age related range 
50+ >3
60+ >4
70+ >5