What is a PSA test

A prostate-specific antigen (PSA) test is a blood test that measures the amount of prostate-specific antigen, a protein produced by the prostate, in the blood.

High levels of PSA in the blood can be a sign of prostate cancer, but they can also be a sign of other prostate conditions. A PSA test alone isn’t enough to diagnose someone with prostate cancer. If PSA test results show a high amount of PSA in the blood, your doctor may recommend more tests, including a follow-up PSA test or a biopsy.

Why might I need a PSA test

Your doctor may suggest a PSA blood test to screen for prostate cancer and other problems with the prostate.

The test can help determine the cause of symptoms, such as painful urination, blood in urine or semen, and pelvic pain. It can also be used to monitor PSA levels in someone undergoing treatment for prostate cancer or after cancer to detect recurrence.

PSA testing guidelines

Unlike with other forms of cancer, such as colorectal cancer, there is no guideline for routine prostate cancer screening in all men. Whether you need PSA testing and the age at which you begin depends on your risk for the condition. Health organizations, including the American Cancer Society and the U.S. Preventive Services Task Force, recommend talking to your doctor about PSA testing.

Generally, those conversations should happen around:

  • Age 50: If you’re at average risk of prostate cancer
  • Age 45: If you’re African American, have a first-degree relative (your father or brother) with prostate cancer or have other risk factors
  • Age 40: If you have had more than one first-degree relative with prostate cancer

PSA test preparation

PSA tests generally don’t require any special preparation, but certain behaviors and medications can skew the results. Releasing semen can temporarily increase PSA levels, so it’s a good idea to refrain from ejaculating a day or two prior to the test. Let your doctor know about all medications and supplements you take and ask whether you should wait to take them until after the PSA test.

The PSA test procedure

Since a PSA test is a simple blood test, the procedure itself is usually easy and quick. If you’re having additional blood tests, such as a cholesterol panel or a complete blood count, a single blood draw will gather the blood samples needed for all tests at once.

What are the risks of a PSA test?

There aren’t any risks associated with the test itself. You might feel a slight pinch as the needle goes into your skin, but the procedure should otherwise be painless. There are, however, some potential harms from PSA testing, which is why routine prostate cancer screening isn’t recommended for everyone.

Potential harms from PSA testing include:

  • False-positive results: A false-positive result suggests you have cancer when you do not. PSA tests can be influenced by many factors, and PSA levels could be high for reasons other than cancer.
  • Overtreatment: Some cancers detected through a PSA test are not considered life-threatening. A PSA test may lead to treatments you don’t need.
  • Unnecessary biopsies: A prostate biopsy helps doctors confirm a prostate cancer diagnosis, but they come with risks. A false-positive result may lead to a biopsy that isn’t necessary.

Understanding PSA test results

Reviewing the results of a PSA test can be a bit confusing. There’s no standard for what defines a normal range for a PSA test, and there’s no specific level that indicates you have prostate cancer or another prostate condition.

In general, though, the higher the PSA level, the more likely it is that someone may have prostate cancer. A PSA test result above 4 ng/mL is considered abnormal, but what’s normal for you may differ depending on factors such as your age and the medications you’re taking.

According to the American Cancer Society, a man with a PSA level between 4 ng/mL and 10 ng/mL has a 25% chance of having prostate cancer, while a PSA level higher than 10 ng/mL is associated with a 50% risk.

When your doctor receives the results of your test, they will review them with you and offer guidance about next steps. They may have you return for another PSA test at a later date or schedule a prostate biopsy to confirm a diagnosis of cancer or another prostate condition.

Frequently asked questions

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