Prostate-specific antigen (PSA) is a protein produced by the glandular tissue of the prostate (a walnut-sized gland just below the bladder and in front of the rectum in males). PSA levels can be detected in the blood, urine, or semen. Blood PSA testing is used as a screening test for prostate cancer.
Prostate-specific antigen (PSA) levels by age remain the same across most populations. A PSA level above 4.0 ng/mL in any age group must be investigated. However, PSA levels can spike in noncancerous conditions, such as benign prostate hypertrophy (BPH), urinary tract infections, prostatitis, consumption of testosterone supplements, recent catheterization, and injuries to the pelvic region.
Start screening for PSA to rule out prostatic cancer starting at age of 55 years. However, you may require PSA screening between the ages of 40 and 54 years in the following situations:
- A first-degree relative (such as your father or brother) or extended family member who has had prostate cancer
- African American ethnicity is at a higher risk of developing aggressive cancers
Points to remember
- PSA levels between 4.0 and 10.0 ng/mL might suggest the possibility of prostate cancer (in about 25 percent of cases) or BPH.
- The PSA levels above 10.0 ng/mL should be urgently discussed with your doctor because these are associated with a 50 percent chance of having prostate cancer.
- The levels from 0.25 ng/mL to 4 ng/mL along with symptoms of prostate enlargement (urinary retention, ejaculation problems, and inability to maintain urine flow) must be investigated further with sonography, a digital rectal examination, and patient history.
Normal PSA level by age chart
| Age | PSA level | Digital rectal examination (DRE) | Course of action |
|---|---|---|---|
| 45 to 75 years | PSA is below 1 ng/mL | Normal | Repeat testing every two to four years |
| 1 and 3 ng/mL | Normal | Repeat testing every one to two years | |
| Greater than 3 ng/mL or your | Indicates abnormality | The doctor may suggest additional testing or a biopsy | |
| You are over 75 years | Continue testing, and if PSA is less than 3 ng/mL | Normal | Repeat testing every one to four years |
| If PSA is greater than 3 ng/ML | Indicates abnormality | The doctor may suggest additional testing or a biopsy |
SLIDESHOW
Screening Tests Every Man Should Have See SlideshowWhat is PSA velocity?
The amount by which the prostate-specific antigen (PSA) levels rise in a year is called PSA velocity. Thus, if the initial PSA reading is about 10 ng/mL and it rises rapidly year on year, this can point to early-stage prostate cancer.
- Most research indicates that an increase of 0.75 ng/mL a year is an early indicator of prostate cancer if a man has a total PSA result between 4.0 and 10.0 ng/mL.
- An increase of 2.0 ng/mL over a year predicts a higher likelihood of death due to aggressive prostate cancer.
- PSA velocity may help predict survivability from prostate cancer.
- Men with a PSA increase of 0.35 ng/ML or less over a year have a 92 percent survival rate.
- Men with PSA levels of more than 0.35 ng/mL over a year have a 54 percent survival rate.
3 other tests for prostate cancer
Early diagnosis and regular screening can aid in both the diagnosis and decision on treatment when it comes to prostate cancers.
- Phi test: The Prostate Health Index (PHI or Phi) combines three blood tests for prostate-specific antigen (PSA), total PSA, free PSA, and pro-PSA. These are different fractions of PSA antigens found in the blood. Experts believe that these values give a more accurate Phi score and better determine the probability of finding cancer during a biopsy.
- PCA3: This is a urine test that accurately detects the risk of prostate cancer by examining the expression of the PCA3 gene, a gene-specific to prostate cancer.
- 4KScore: Another blood test measures total PSA, free PSA, intact PSA, and certain enzymes called kallikrein. A special computer-based algorithm used with the patient’s age and physical exam gives a probability of having aggressive prostate cancer.
However, none of these tests are conclusive on their own. When performed in addition to a PSA test, a digital rectal exam and biopsy can provide more information about specific cancer.
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Johns Hopkins Medicine. Prostate Cancer: Age-Specific Screening Guidelines. https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostate-cancer-age-specific-screening-guidelines
ZERO - The End of Prostate Cancer. PSA Screening. https://zerocancer.org/learn/about-prostate-cancer/detection-diagnosis/psa-test/
Top What Is a Normal PSA Level by Age Related Articles
Can Prostate Cancer Kill You?
Yes. Like any other cancer, prostate cancer is a potential killer. However, this is true of the metastasized prostate cancer that has remained undiagnosed for a long time. The disease is vastly curable when diagnosed early.
Early-Stage Prostate Cancer Treatment
If prostate cancer is detected early and appears to be slow-growing, invasive procedures, chemotherapy, radiation and other approaches can sometimes do more harm than good. Many prostate cancer treatments come with side effects, like incontinence or impotence, so it’s in the patient’s interest to put off invasive treatments as long as is medically safe. Active surveillance is where doctors "watch and wait" for changes that could prompt medical intervention.
How Is Prostate Cancer Diagnosed?
Prostate cancer is largely a disease of men over 40, so it’s around this age doctors recommend the first prostate screening. The first exam is a blood test to determine if there are abnormal prostate specific antigen (PSA) levels in your blood – PSA is produced by the prostate. If the PSA is high, your doctor will perform a digital rectal exam, during which the doctor feels your prostate from inside your rectum with a gloved finger. Other diagnostic tests include an endoscopic biopsy of tumor tissue for analysis in a lab.
How Quickly Does Prostate Cancer Spread?
Prostate cancer is a cancer that develops in the prostate gland in men and it is one of the most common types of cancer. In some cases, it can take up to eight years to spread from the prostate to other parts of the body (metastasis), typically the bones. In other cases, it may be more aggressive.
Prostate Cancer
Prostate cancer is the most common cancer in men after skin cancer.
- Risk factors include age, family history, ethnicity, and diet.
- Prostate cancer is diagnosed by a digital rectal exam, prostate-specific antigen (PSA) test, and prostate biopsy.
- Symptoms may include
- frequent need to urinate,
- incontinence, pain,
- blood in the urine,
- fatigue, and more.
- Prognosis and treatment depend on cancer staging.
- Watchful waiting,
- surgery,
- radiation,
- cryotherapy, and
- other management strategies are available.
- Research and clinical trials strive to find new and better treatments for prostate cancer.
Prostate Cancer Quiz
Is prostate cancer the most common cancer in men? Take this prostate cancer quiz to find out and learn the causes, symptoms, and treatments of this disease.
Prostate Cancer Facts
Prostate cancer is a leading cause of cancer and cancer death in males; in some men, identifying it early may prevent or delay metastasis and death from prostate cancer.
- The prostate is a walnut-shaped gland that is a part of the male reproductive system that wraps around the male urethra at it exits the bladder.
- Prostate cancer is common in men over 50 years of age, with the risk of developing prostate cancer increases with aging.
Things That May Slow Prostate Cancer Progression
Studies are ongoing, but are there certain foods and healthy practices that can slow the growth of tumors in the prostate? Learn what could help with this WebMD slideshow.
testosterone gel
Testosterone gel is a topical medication containing testosterone and is prescribed for the treatment of low testosterone levels. The most common side effects of testosterone gel are headache, high blood pressure, acne, abnormal lab tests (for example, glucose and cholesterol tests), application site reactions (for example, itching, blisters, and redness), enlarged prostate, and increased serum prostate specific antigen (PSA) levels.The Early Signs of Prostate Cancer
Prostate cancer in its early stages usually causes no signs and symptoms. Screening can help detect the cancer early.
What Age Does Prostate Cancer Risk Increase?
Prostate cancer risk increases with age, especially after age 50. Most prostate cancers are diagnosed between the ages of 65-69.What Are the 4 Stages of Prostate Cancer?
Prostate cancer is cancer that develops in the prostate glands of men. It is one of the most common types of cancer. It is usually seen in men older than 50 years of age. The prostate is a small walnut-shaped gland in men that produces seminal fluid. This fluid nourishes and transports sperm.What Are the 5 Warning Signs of Prostate Cancer?
Prostate cancer rarely produces symptoms in the early stage; however, few signs can help in detecting prostate cancer.
What Are the Key Signs of Prostate Cancer?
Learn the 23 key signs that may indicate the presence of prostate cancer below.
What Foods Kill Prostate Cancer?
Prostate cancer refers to the uncontrolled growth of cells in the prostate gland. There is no particular food or recipe that can directly kill prostate cancer cells. Some foods that may be helpful in prostate cancer recovery and relapse prevention include foods containing lycopene, beans, green tea, cruciferous vegetables and fruit like cranberries, strawberries, blueberries and pomegranates.