Prostate-Specific Antigen (PSA) and PSA elevation
About PSA testing
Prostate-specific antigen (PSA) is a protein made by the cells of the prostate. It is also the part of semen that keeps it
“watery.” Although most of a man’s PSA is carried out of the body during ejaculation, trace amounts of it enter the blood
stream.
A man’s PSA level can be measured through a routine blood test. A laboratory method called immunoassay is used to generate
the results, which are reported in nanograms per milliliter (ng/ml). Many factors may contribute to the interpretation of
a PSA test. As a general rule, the following can be used:
- For men under age 60, a level of 0-2.5 ng/ml is considered “low”; 2.5-4 ng/ml is “medium”; greater than 4 ng/ml is “high.”
- For men over age 60, the normal levels may be slightly higher.
Measuring PSA levels can be a helpful tool in early detection of prostate cancer. However, a physician cannot diagnose prostate
cancer based only on a PSA level. This blood test should be performed in conjunction with a digital rectal examination (DRE).
Based on this information, a biopsy at the prostate may be recommended to definitively diagnose the condition.
When your PSA level is elevated
Sometimes, an elevated PSA level doesn’t mean anything. For instance, as men age, PSA levels naturally rise. Thus, under normal
circumstances, a 70-year-old man’s PSA level is expected to be higher than that of a 40-year-old man.
In addition, men may have an elevated PSA due to benign prostatic hyperplasia (BPH), prostatitis, sexual activity, or recent surgery of the prostate. Quite simply, an increased PSA level does not always mean
that prostate cancer or other conditions are present. When physicians observe an elevated PSA in conjunction with an abnormal
DRE, they will typically order additional tests, such as a prostate biopsy.
When to test
Jefferson urologists recommend that men begin annual testing as follows:
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African-American men without a family history of prostate cancer should start at age 40.
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African-American with a family history of prostate cancer should start at 35.
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Caucasian men without a family history of prostate cancer should start at 50.
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Caucasian men with a family history of prostate cancer should start at 40.
If your preliminary PSA and DRE are normal, you should continue with annual screenings. If your results are elevated or otherwise
abnormal, your physician may ask you to come back for more frequent follow-up testing.
Thomas Jefferson University and the Kimmel Cancer Center at Jefferson also offer the latest investigative technologies to
diagnose prostate cancer.
Prostate Diagnostic Center
