PSA Test

PSA Test Results

The results of your PSA test report the level of PSA detected in the blood. The results are usually reported as nanograms of PSA per milliliter (ng/mL) of blood.
In the past, most doctors considered PSA values below 4.0 ng/mL to be normal. However, recent research found prostate cancer in men with PSA levels below 4.0 ng/mL. Thus, many doctors are now using the following ranges, with some variation:
  • 0 to 2.5 ng/mL is low
  • 2.6 to 10 ng/mL is slightly to moderately elevated
  • 10 to 19.9 ng/mL is moderately elevated
  • 20 ng/mL or more is significantly elevated.
There is no specific normal or abnormal PSA level. However, the higher a man's PSA level, the more likely it is that cancer is present. However, because various factors can cause PSA levels to fluctuate, one abnormal PSA test does not necessarily indicate a need for other diagnostic tests.
When PSA levels continue to rise over time, other tests may be needed.

Elevated Levels in a PSA Test

A man should discuss elevated PSA test results with his doctor. There are many possible reasons for an elevated level, including:
  • Prostate cancer
  • Benign prostate enlargement (BPH)
  • Inflammation
  • Infection
  • Age
  • Race.
If no other symptoms suggest cancer, the doctor may recommend repeating the digital rectal exam and PSA test regularly to watch for any changes. If a man's PSA levels have been increasing, or if a suspicious lump is detected during the digital rectal exam, the doctor may recommend other tests to determine if there is cancer or another problem in the prostate.
A urine test may be used to detect a urinary tract infection or blood in the urine. The doctor may recommend imaging tests, such as:
  • Ultrasound (a test in which high-frequency soundwaves are used to obtain images of the kidneys and bladder)
  • X-rays
  • Cystoscopy (a procedure in which a doctor looks into the urethra and bladder through a thin, lighted tube).
Medicine or surgery may be recommended if the problem is BPH or an infection.
If cancer is suspected, a biopsy is needed to determine if cancer is present in the prostate. During a biopsy, samples of prostate tissue are removed, usually with a needle, and viewed under a microscope. The doctor may use ultrasound to view the prostate during the biopsy, but ultrasound cannot be used alone to tell if cancer is present.
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