Prostate-Specific Antigen Test
A prostate-specific antigen (PSA) test is a blood test that may be offered to you as routine screening in the context of a checkup by a primary care physician or urologist.
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But using the test for routine screening is tricky. Elevated results on a PSA test may occur for reasons other than cancer, such as an enlarged prostate, benign prostatic hyperplasia, or an infection in the prostate called prostatitis.
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Men who receive an elevated result may be referred for further testing. For this reason, the test should only be performed after an informed conversation between the doctor and the patient, with an emphasis on shared decision-making.[5]
The American Urological Association (AUA) and Society of Urologic Oncology (SUO) recommend PSA tests for those at high risk for prostate cancer starting at age 40 to 45. You’re considered at high risk if you are Black, have a family history of prostate cancer, or carry specific genetic mutations, such as BRCA.
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If you’re not at high risk, the AUA and SUO recommend a baseline PSA test and prostate cancer screening around the age of 45 to 50, with regular prostate cancer screenings every two to four years for those ages 50 to 69. These screening timelines may be adjusted based on your personal risk, health, or preferences.
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The American Cancer Society uses these parameters to evaluate PSA results:
- A PSA test result below 4 nanograms per milliliter (ng/mL) means that 85 percent of the time, you won’t have prostate cancer.
- A PSA result between 4 and 10 ng/mL is associated with a 1 in 4 chance of having prostate cancer.
- If your PSA result is greater than 10 ng/mL, you have a 1 in 2 chance of having prostate cancer.
But doctors have not adopted a uniform system for interpreting PSA. Thresholds for concern and reference ranges vary, and different medical societies may have varying recommendations.
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If your PSA test results are elevated, you will likely be advised to have more tests.
