The PSA test is the leading method of screening for prostate cancer. PSA screening can help catch the disease at an early stage when treatment may be more effective and potentially have fewer side effects. The PSA test may be done along with a digital rectal exam (DRE), in which a physician inserts a gloved finger into the rectum to examine the prostate for irregularities.
PSA, or prostate-specific antigen, is a protein produced by the prostate and found mostly in semen, with very small amounts released into the bloodstream. When there’s a problem with the prostate—such as the development and growth of prostate cancer—more PSA is released. Sometimes, a man’s prostate releases slightly high PSA for other reasons. Rising PSA eventually reaches a level where it can be easily detected by a blood test.
For more information on rising PSA, download or order your free copy of the Prostate Cancer Patient Guide.
During a PSA test, a small amount of blood is drawn from the arm, and the level of PSA, a protein produced by the prostate, is measured. A higher PSA means that there is a greater chance that you have prostate cancer. Historically, a PSA of 3 or 4 was considered as the threshold of “normal” vs “abnormal.” However, we now know that it’s more complicated, and a high PSA does not necessarily mean that a man has prostate cancer. In some (rare) cases, cancer can be present even when PSA levels are lower.
Your doctor will consider several factors when evaluating the results of your PSA test, such as your age (PSA rises with age). If you have had multiple PSA tests, your doctor will look at the trend, and any rate of rise over time (PSA velocity).
Remember that assessment of PSA must also take into account:
PSA screening is just the first step, alerting you and your doctor that more testing may be needed. If PSA is only slightly elevated, your doctor may recommend repeating the test a couple of weeks later. From there, other types of tests can help with the decision on whether you need a biopsy, including:
Each time you see your doctor for a checkup, have a conversation about prostate health and prostate cancer screening. PCF recommends that you make a shared decision about PSA screening with your doctor, starting at age 45, or age 40 if you have a family history of prostate or other cancers or are Black.
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