PSA screening for Prostate Cancer

25 years ago before the time we use PSA screening, about 1/5 of men who diagnosed had advanced disease prostate cancer.

What is Prostate-Specific Antigen?

PSA is a protein produced by prostate cells, which keeps semen in liquid form so that sperm can swim. A simple blood test can measure how much PSA is present in a man’s bloodstream. When a man has prostate cancer, his PSA level increases, which is why the PSA test is used as a screening tool.

However, the levels of PSA can rise due to a number of reasons, including cancer. When PSA is elevated it is a warning sign that you should follow up on with your doctor.

Other causes that can increase PSA level

  • Prostatitis ( prostate gland inflammation )

  • Riding a bicycle

  • Sex (within the past 24 hours)

  • Supplements that effect testosterone

  • Urinary tract infection

  • Advanced age

  • Recent biopsy

  • Catheter

  • Injury to pelvic region or prostate

PSA level when should I check?

Understanding Your PSA Test

In general, a PSA level that is above 4.0 ng/mL is considered suspicious.

Here are general PSA level guidelines:

  • 0 to 2.5 ng/mL is considered safe

  • 2.6 to 4 ng/mL is safe in most men but talk with your doctor about other risk factors

  • 4.0 to 10.0 ng/mL is suspicious and might suggest the possibility of prostate cancer. It is associated with a 25% chance of having prostate cancer.

  • 10.0 ng/mL and above is dangerous and should be discussed with your doctor immediately. It is associated with a 50% chance of having prostate cancer.

However, PSA levels can easily rise with greater age. You and your physician should consult age-specific normal PSA ranges.

Age adjust PSA level

All age < 4

40-49 yrs < 2.5

50-59 yrs < 3.5

60-69 yrs < 4.5

> 70 yrs < 6.5

If Your PSA is Rising Quickly

The rate of yearly increase in the PSA level is known as the PSA velocity. This is one measure of prostate cancer risk since PSA levels can rise rapidly in men who have prostate cancer. This can be especially useful to find prostate cancer in the early stages before cancer has left the capsule of the prostate.

Research shows that an increase of .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. Further, an increase of 2.0 ng/mL over a year period predicts a higher likelihood of death due to aggressive prostate cancer

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