psa test

Prostate-specific antigen (PSA) is a protein produced by cells of the prostate gland that can be detected in blood. Blood PSA levels typically rise in men who have prostate cancer. Since the 1990s, the PSA test has been used, along with the digital rectal exam (DRE), to regularly screen men over age 50 for prostate cancer.

The trouble is, noncancerous prostate conditions such as prostatitis (prostate inflammation) and benign prostatic hyperplasia (BPH) can also cause a rise in PSA level. Urinary tract infections, prostate surgery, bladder tests, certain medications (such as NSAIDs, statins, and diuretics), and recent ejaculation can also affect PSA test results. The difficulty in distinguishing prostate cancer from these benign conditions can contribute to false positive results, which can lead men to have unnecessary biopsies (the removal of prostate tissue to test for cancer). Some evidence has shown that only 25 percent of men who have undergone a prostate biopsy because of a high PSA level actually have prostate cancer.

Even when a PSA test correctly identifies prostate cancer, it?s hard to know whether that cancer will be life-threatening. Many prostate cancers are slow growing and don?t need treatment. A high PSA level may result in men being treated for cancers they don?t have or that wouldn?t have spread, exposing them to treatment side effects and unnecessary anxiety.

Doctors have also had difficulty agreeing on what constitutes a ?normal? PSA level. In the past, a PSA of 4 nanograms per milliliter of blood (ng/ml) was considered normal. However, more recent students have shown that some men with PSAs below 4 have prostate cancer, while some men with PSA levels over 4 do not have cancer.

As a result, many medical organizations have pulled back on their recommendation that men get routine PSA screening. Most groups agree that screening should be individualized based on a man?s age, risk factors, and overall health.

What Can Skew a PSA Test? These 10 Factors Can Affect Your Numbers

It’s well known that the prostate-specific antigen (PSA) test used to screen for prostate cancer is imprecise. Elevations in PSA levels may signal prostate cancer, but they also may be due to nonmalignant prostate conditions. Further complicating the screening process is that several medications and a number of other modifiable … Read More

What Is Prostate Cancer?

The vast majority of prostate cancers originate in the glandular cells of the prostate and are called adenocarcinomas. Prostate cancer is second only to skin cancer as the most common cancer seen in men in the United States. While most men do not die from prostate cancer, it is the … Read More

Is There a Normal PSA Level?

There is no universally accepted "normal" PSA level. In the past, a PSA of 4 nanograms per milliliter of blood (ng/ml) or less was considered normal; however, more recent studies have shown that some men with PSAs below 4 have prostate cancer and some men with PSAs over 4 do … Read More

Don’t Rush to Surgery for Prostate Cancer

After skin cancer, prostate cancer is the most common cancer in men, according to the American Cancer Society (ACS)—and six cases in 10 occur in men age 65 and older. For some men, prostate cancer can be an aggressive disease, but for most, the disease is slow growing—in fact, men … Read More

Beyond the PSA Test: Options for Screening

Prostate screening traditionally has focused on two methods: the digital rectal exam (DRE) and prostate specific antigen, or PSA testing. Researchers have always worked toward improving the accuracy and reliability of both modalities. Along the way, PSA test options have been surfacing. New methods seek to clarify diagnoses in men … Read More

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