PSA Test (Prostate Specific Antigen)

  • Medical Author: Pamela I. Ellsworth, MD
  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Quick GuideScreening Tests Every Man Should Have

Screening Tests Every Man Should Have

What are normal results for the PSA test?

The "normal" PSA serum concentration remains a debate, however, for most laboratory readings, it should be less than 4.0 ng/mL. The prostate gland generally increases in size and produces more PSA with increasing age, so it is normal to have lower levels in young men and higher levels in older men. Due to these normal changes in PSA with age, the concept of age-adjusted PSA normals have been described and recommended. What is considered to be a normal PSA level also depends on ethnicity and family history of prostate cancer. Other than the single reading, the changes in PSA numbers on an annual basis (also referred to as PSA-velocity) also play a role in decision making about the PSA marker. The normal increase of less than 0.75 ng/mL is used to help determine whether levels may be suggestive of disease and to counsel men on management. As such, a man 50 to 59 years of age with an increase in PSA levels from 0.5 ng/mL to 2.5 ng/mL may have prostate cancer despite the normal value at that time. Lastly, as the size of the prostate gland may affect the PSA level, PSA density (PSA level divided by prostate volume) can also be a helpful number. A PSA density of 0.18 appears to be an optimal number.

What are age-specific reference ranges for serum PSA?

The use of age-specific PSA ranges for the detection of prostate cancer is helpful to avoid unnecessary investigations in older men with larger prostate glands. Median PSA value for men aged 40 to 49 years is 0.7 ng/mL and for men 50 to 59 years is 0.9 ng/mL. Not all studies have agreed that this is better than simply using a level of 4.0 ng/mL as the highest normal value. Nevertheless, due to the age-related growth of the prostate, the concept of adjusting the cutoff values based on age has helped reduce unnecessary prostate biopsies in older men to improve early prostate cancer detection. Below are the suggested age-adjusted values based on age and race.

PSA levels chart

Age-Specific Reference Ranges for Serum PSA
Age Range (Years)Asian AmericansAfrican AmericansCaucasians
40 to 490 to 2.0 ng/mL0 to 2.0 ng/mL0 to 2.5 ng/mL
50 to 590 to 3.0 ng/mL0 to 4.0 ng/mL0 to 3.5 ng/mL
60 to 690 to 4.0 ng/mL0 to 4.5 ng/mL0 to 4.5 ng/mL
70 to 790 to 5.0 ng/mL0 to 5.5 ng/mL0 to 6.5 ng/mL

Medically Reviewed by a Doctor on 2/1/2017

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