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Prostate-Specific Antigen Total

Cancer screening Biomarker

Sample Needed

Collection Type: Blood

Body System

Related System: Cancer screening

Overview

Prostate-Specific Antigen (total PSA) is a protein produced by prostate gland cells and released into the blood. The total PSA test measures the combined amount of bound and free PSA in serum. It is used primarily for prostate cancer screening and for monitoring known prostate disease. Elevated PSA can suggest prostate cancer but also benign prostate enlargement (BPH), prostatitis or recent prostate manipulation. Symptoms that commonly prompt testing include urinary frequency, weak stream, nocturia, blood in urine or ejaculate, pelvic pain, or a family history of prostate cancer. PSA levels normally rise with age and larger prostate volume; the test is relevant to biological males (and people with a prostate), and interpretation is adjusted for age, medications and recent procedures.

Test Preparation

  • It is advisable to avoid sexual intercourse, ejaculation, and vigorous exercise for up to 48 hours before sample collection
  • Do not give sample within 7 days of Digital Rectal Examination (DRE) or Rectal Prostatic Ultrasonography
  • Prostate biopsy causes a substantial elevation of the PSA levels
  • Talk to your doctor about the appropriate timing of the test

Why Do I Need This Test

  • Profile: Cancer screening - Symptoms: Lower urinary tract symptoms, hematuria, pelvic pain, or suspicious digital rectal exam - Conditions: Detect/monitor prostate cancer, BPH, prostatitis; follow response to treatment - Abnormal levels may result from cancer, inflammation, enlargement, recent ejaculation or prostate manipulation - Biological meaning: high PSA signals increased prostate cell activity or leakage into blood - Lifestyle/family: recent ejaculation, cycling, urinary infection, and a family history of prostate cancer increase need for testing

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Symptom Checker

Understanding Test Results

  • PSA <0.5–2.5 ng/mL: generally low risk for clinically significant prostate cancer (younger men toward lower end).
  • PSA 2.5–4.0 ng/mL: borderline consider age, prostate volume and trend; may prompt surveillance.
  • PSA 4.0–10.0 ng/mL (“gray zone”): intermediate risk; further evaluation recommended (repeat test, free/total PSA ratio, mpMRI or biopsy).
  • PSA >10 ng/mL: substantial risk of prostate cancer; biopsy usually indicated.
  • PSA >20 ng/mL: high likelihood of advanced or metastatic disease and requires urgent specialist assessment.
  • Transient rises can occur after ejaculation, DRE, catheterization, recent biopsy, prostatitis or UTI repeat testing after 4–8 weeks is often advised.
  • Medications (5α-reductase inhibitors) lower PSA approximately 50% and must be accounted for when interpreting results.

Normal Range

0-4.0 ng/mL

FAQs

Q: What does it mean if your prostate-specific antigen is high?

A: A high prostate-specific antigen (PSA) means there’s an increased prostate protein level. Causes include benign prostatic enlargement, prostatitis or urinary infection, recent urological procedures or ejaculation, and less commonly prostate cancer. PSA also rises with age. A single high result isn’t diagnostic; clinicians usually repeat the test, perform a physical exam and may use imaging or biopsy to determine the cause and next steps.

Q: What is a normal prostate-specific antigen level?

A: Normal PSA varies by age and lab. Traditionally a total PSA below 4.0 ng/mL is considered normal, but age-specific cutoffs are often used: about <2.5 ng/mL (40–49), <3.5 ng/mL (50–59), <4.5 ng/mL (60–69), and <6.5 ng/mL (70–79). Levels can rise from benign enlargement, infection, recent procedures, or medications; abnormal results require clinician assessment.

Q: What will happen if PSA is high?

A: A high PSA suggests increased prostate activity but is not a definitive cancer diagnosis. Causes include prostate cancer, benign prostatic hyperplasia, prostatitis, recent ejaculation, urinary retention, or instrumentation. Doctors usually repeat the test, perform a digital rectal exam, check free/total PSA and PSA velocity, and may order imaging or a biopsy if levels remain elevated or clinical suspicion is high.

Q: What is the danger range for PSA?

A: PSA under about 4 ng/mL is generally considered low risk; 4–10 ng/mL is a “gray zone” with moderate cancer risk; values above 10 ng/mL are associated with a substantially higher likelihood of prostate cancer. Age-specific norms and PSA velocity (rapid rise) matter; any persistent elevation or sudden increase should prompt urological assessment and further testing (imaging or biopsy).

Q: How can I reduce my prostate antigen?

A: PSA (prostate-specific antigen) can fall by treating underlying problems and healthy changes. Get evaluated for prostatitis or BPH and follow prescribed treatments (antibiotics, alpha‑blockers or 5‑alpha‑reductase drugs when indicated). Lifestyle: maintain healthy weight, exercise, eat more fruits/vegetables, reduce red meat and saturated fat, limit alcohol and smoking. Avoid recent ejaculation or strenuous cycling before retesting and see your doctor.

Q: What is the normal PSA for a 70 year old man?

A: For a 70‑year‑old man, a commonly accepted upper limit for prostate‑specific antigen (PSA) is about 6.5 ng/mL. PSA levels rise with age, so age‑adjusted cutoffs are used rather than a fixed 4 ng/mL. Individual interpretation depends on symptoms, PSA trend over time, medications, and clinical context; discuss results and next steps with a clinician.

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