A prostate-specific antigen (PSA) test is used in conjunction with a DRE (digital rectal examination) to evaluate your prostate for any abnormalities. Since the PSA result is age specific, consult your urologist for its correct interpretation.

Essentials of PSA Tests

Your doctor often uses a PSA test to screen for prostate cancer. An elevated PSA by itself does not always mean that cancer is present. It simply alerts your doctor to evaluate your prostate.

There are other medical conditions that can cause your PSA level to increase. These conditions include an enlarged prostate (Benign Prostatic Hyperplasia (BPH), an inflamed prostate (prostatitis), or a urinary tract infection.

In the blood stream, PSA can either float freely or attach to other proteins. Men with cancer often have lower levels of free PSA compared to those whose elevated PSA is due to other causes.

The introduction of total and free PSA has been extremely helpful. The lower the percentage of free PSA, the greater the likelihood of prostate cancer. Evaluating the free PSA level is extremely beneficial in men with serum PSA concentrations between 4 and 10 ng/mL.

Age-specific PSA

In younger men with PSA levels between 2 and 4 ng/mL, a much more aggressive approach is taken in terms of getting an early biopsy. In older patients, 4 ng/ML is recognized as a cutoff point.

PSA velocity

PSA velocity, which measures the rate of rise compared to the previous PSA level, is also taken as an indicator for further diagnostic testing.

If your PSA level is high, what should be done next?

Your doctor may repeat the test or perform additional tests to provide an accurate diagnosis.