Prostate Specific Antigen (PSA) is a protein produced in the ducts of the prostate. PSA is released with the ejaculatory fluid (semen) and helps semen flow more easily2.
PSA is produced by both normal and malignant prostate cells, and is absorbed into the bloodstream. The amount of PSA found in the blood stream can be measured and aid in providing information regarding prostate health2.
This page is a resource to help you learn more about PSA testing so that you can take better control of your health and make the decisions that are right for you.
What is PSA testing?
A PSA blood test, measures the amount of PSA found in the blood. The PSA level that is considered normal for an average man increases with age and can range from 0 to 4 nanograms per milliliter (ng/ml)2.
PSA levels in the blood increases with prostate size, age, and can also increase with prostate disease such as BPH, prostate cancer and prostatitis (infection of the prostate)2. The PSA test can be combined with a digital rectal exam for a more accurate guide to early cancer detection. Based on PSA testing, physicians can plan a procedure roadmap to manage or remedy a prostate condition, or they can monitor if prostate cancer has returned1.
Who qualifies for PSA testing?
Men who are at an average risk of developing prostate cancer should consider PSA testing beginning at age 50. Men with certain risk factors such as a family history of prostate cancer, or Black men (including those of African or Caribbean ancestry), should consider testing starting at age 45.1
When your PSA levels are high, your doctor can work with you to determine what the causes are and go over all follow-up options and next steps. It is important to note that there are a variety of limitations associated with PSA testing as it may not be the right course of action for everyone. Your doctor can help you decide your risk levels and what testing is right for you1.
What if your PSA levels are high?
Follow-up care, such as additional tests or a biopsy may be required if it is established that your PSA levels are high after a PSA test. Here are some examples of additional testing:
Serial PSA Testing
Serial PSA Testing looks at changes and possible irregularities that have occurred overtime. This type of testing helps track patterns in your PSA levels rather than relying on a single test result.
Free and Bound PSA
Free PSA means the protein circulates within the blood freely and Bound PSA meaning the PSA is attached to other proteins. This test helps distinguish between different types of PSA in your blood, which can provide more specific information about your prostate health.
PSA Density (PSAD)
PSA Density (PSAD) looks at the PSA in the blood in relation to the volume of the prostate. This calculation helps doctors understand if elevated PSA levels are proportional to prostate size or may indicate other concerns.
Nomograms
Nomograms encompass a variety of factors to help predict an outcome, from age to ethnicity, symptoms and more. These tools combine multiple data points to provide a more comprehensive risk assessment tailored to your individual profile.
References
- Canadian Cancer Society. (2020). Prostate-Specific Antigen (PSA) Test. Retrieved from: https://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/tests-and-procedures/prostate-specific-antigen-psa/?region=on
- National Cancer Institute. (2011, August). Understanding Prostate Changes. Retrieved from: https://www.cancer.gov/types/prostate/understanding-prostate-changes/prostate-booklet.pdf