Prostate-Specific Antigen (PSA) Testing | Elevated PSA | PSA Test | MedStar Health

A PSA test is a simple and quick way to screen for prostate cancer.

Prostate-Specific Antigen (PSA) is a protein made in the prostate gland and found in semen. Small amounts of this protein make their way into the blood and can tell doctors if there are problems with the prostate through a PSA blood test.

PSA is often elevated in men with prostate cancer, making a PSA screening test the best tool for early detection. However, the PSA can be elevated due to other benign conditions and does not necessarily mean that there is prostate cancer present. Therefore, screening for prostate cancer typically includes the PSA blood test combined with a digital rectal examination (DRE) of the prostate.

There are conflicting opinions on who should be screened for prostate cancer using the PSA test. Ultimately it should be a shared decision made by you and your doctor, who will help you weigh the pros and cons based on your risk factors.

About PSA screening

This type of screening can detect prostate cancer early, which can help you get timely treatment before it becomes advanced and much harder to treat. The test typically takes around 20 minutes and can be completed in your primary care doctor's office or at a local lab. There isn't much you need to do to prep, although you may want to avoid biking or sexual activity 24 hours beforehand. Most major health insurances cover one prostate cancer screening every year. If you have urologic-related symptoms, your insurance may cover you for additional tests, as needed.

The test is straightforward, but the results aren't always. A PSA screening can detect high prostate-specific antigen levels, but an elevated level doesn't mean you will develop prostate cancer. An inflamed or enlarged prostate can also result in elevated PSA. That's why it's important to have your test results analyzed by an experienced urologist. If your PSA level is high, a doctor trained in urology will discuss your results and recommend next steps.

Men with average risk should talk to their doctor about getting their PSA levels checked starting at age 50.

There are certain things that can increase your prostate cancer risk, including:

  • Having a family history of the disease
  • Being African American
  • Knowing you have a genetic mutation associated with prostate cancer (e.g., the BRCA genes)

If you have an average risk of prostate cancer, we recommend you start having conversations with your doctor about PSA screenings beginning at the age of 50 and continuing through 70. If your risk is low, your doctor may suggest less frequent screenings.

However, if you have a high risk of developing prostate cancer, your doctor may recommend earlier or more frequent PSA tests. For example, if your brother was diagnosed with prostate cancer, you may benefit from annual screening starting at 50.

Frequently asked questions

  • What is a normal PSA?

    Most doctors agree that a normal PSA is between 0 and 4.0 ng/ml for the most common PSA tests. However, if your doctor uses a different PSA test, the results may be interpreted differently.

    PSA is usually high in men with prostate cancer. However, some men may have high PSA in their blood and not have prostate cancer. That is why it is important to be seen by a urologic oncologist with experience in treating this form of cancer.

  • Why does PSA rise?
    If the prostate cells begin to break down or make more of the protein, they will escape into the blood. This causes the numbers to become elevated, signaling that there may be a problem with prostate function.
  • What do the results mean?

    Any PSA test result higher than 4.0 ng/ml usually signals a problem with the amount of PSA in the blood. There is a reason why the PSA level in your blood is higher. However, it does not always mean that you have cancer.

    If your PSA is elevated, one of our specially-trained urologists will determine what your next steps should be. PSA is only one tool for diagnosing prostate cancer. A digital rectal exam and other imaging techniques, including a prostate biopsy, will be used to diagnose prostate cancer.

    If a biopsy confirms prostate cancer, you can trust that we have the technology and experience necessary for delivering the best possible care. We treat more patients for prostate cancer than most health systems in the region, and you'll benefit from the latest discoveries in prostate cancer care that lead to excellent outcomes.

  • How often should I be tested?

    We recommend repeating the test annually at your annual physical. However, if your PSA levels are elevated, your doctor may recommend testing more often.

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