What is the PSA Test?

The Prostate-Specific Antigen (PSA) test is a simple blood test used to measure the levels of PSA—a protein produced by the prostate—circulating in the bloodstream. It is the primary screening tool for prostate cancer and is often the first step in detecting potential issues.

However, while an elevated PSA level can be a warning sign, it does not necessarily mean cancer is present. Other conditions, such as an enlarged prostate (BPH) or prostate infections, can also cause PSA levels to rise.

Beyond screening, the PSA test plays a crucial role in monitoring prostate cancer treatment. If a man undergoes treatment—such as surgery, radiation, hormone therapy, or chemotherapy—his PSA levels should drop significantly. Doctors use regular PSA tests to track changes and detect potential cancer recurrence.

What is Prostate-Specific Antigen (PSA)?

PSA is a protein naturally produced by the prostate. Its primary function is to keep semen in liquid form, allowing sperm to swim efficiently.

In most cases of prostate cancer, PSA levels rise, making the PSA test a valuable early detection tool. However, the test alone cannot diagnose cancer, and additional tests—such as a biopsy or MRI—may be needed for confirmation.

Why is PSA Testing Important?

  • Early detection of prostate cancer, when it is most treatable.
  • Monitoring cancer progression in men undergoing active surveillance.
  • Tracking treatment effectiveness and identifying potential recurrence.

While the PSA test is not perfect, it remains a vital tool in prostate health management. Men should discuss the benefits and limitations of PSA testing with their doctor to make informed decisions about their screening plan.

Understanding Your PSA Test Results

To interpret your PSA (prostate-specific antigen) levels accurately, refer to the “Prostate Cancer Early Detection: Age Recommendations and PSA Levels Chart.” Generally, the following guidelines can help you and your doctor assess your results based on age:

  • Under 49 years old: A PSA level above 2.0–2.5 ng/mL may warrant further evaluation.
  • Ages 50 to 75: A PSA level higher than 3.0–3.5 ng/mL could be a concern.
  • Over 75 years old: PSA levels above 4.0 ng/mL may require additional testing.

What Does a High PSA Level Mean?

If your PSA level is elevated, don’t panic—there are multiple steps you and your doctor can take. One approach is to repeat the PSA test, as studies show that a second screening can increase the accuracy of the results. Other diagnostic tools include a digital rectal exam (DRE) and, if needed, a prostate biopsy to confirm whether cancer is present. It’s also important to note that elevated PSA levels don’t always indicate cancer. Factors like age, recent ejaculation, or cycling within the past 24 hours can also cause temporary increases in PSA.

If your PSA is high, have an open conversation with your doctor about recent activities, medications, and your health history. Additional diagnostic tests may be recommended based on your overall risk profile.

What If My PSA Level Is Low?

A low PSA level is typically a positive sign. However, certain factors can lower PSA readings artificially, such as cholesterol-lowering statins, anti-inflammatory medications, or excess body fat, which can dilute PSA levels in the blood. Be sure to share any relevant medications or conditions with your doctor during the evaluation.

What If My PSA Level Is Increasing Rapidly?

The rate at which your PSA level rises over time is called PSA velocity. A rapid increase may be an early warning sign of prostate cancer and is one of the indicators doctors use to assess your risk. Monitoring PSA velocity can help detect prostate cancer in its early stages, potentially before it spreads beyond the prostate.