Prostate-Specific Antigen Testing (PSA)

A PSA test can be used for a number of reasons:

• Prostate Cancer Screening: PSA testing may be used to help detect prostate cancer, especially in men over the age of 50 or those with a family history of prostate cancer.
• Monitoring Prostate Cancer: If you have been diagnosed with prostate cancer, PSA levels may be monitored to track the effectiveness of treatment or detect recurrence.
• Detecting Prostate Problems: Elevated PSA levels can also indicate other prostate issues such as benign prostatic hyperplasia (BPH) or prostatitis (inflammation of the prostate).

PSA levels are measured in nanograms per millilitre (ng/mL). While there is no exact "normal" level for PSA, general guidelines are as follows:

Normal Range: Typically, a PSA level below 4.0 ng/mL is considered normal. However, levels can vary depending on age and individual health factors.

Elevated PSA: A PSA level higher than 4.0 ng/mL may indicate a potential issue with the prostate, such as an enlarged prostate (BPH), prostatitis, or prostate cancer. However, a raised PSA does not necessarily mean you have cancer, as non-cancerous conditions can also cause elevated PSA levels.

Very High PSA: PSA levels above 10 ng/mL may suggest a higher likelihood of prostate cancer, but further tests such as a biopsy or imaging may be required to confirm this.

PSA levels can be influenced by various factors, including:

• Age: PSA levels tend to increase naturally with age.
• Prostate Size: An enlarged prostate (BPH) can cause higher PSA levels.
• Prostate Infections or Inflammation: Conditions such as prostatitis can raise PSA levels.
• Recent Ejaculation or Prostate Examination: Sexual activity or a digital rectal exam (DRE) within 24 hours may cause a temporary increase in PSA.

An elevated PSA does not automatically mean you have prostate cancer. If your results show a high PSA level, your doctor may recommend additional tests, such as:

Repeat PSA Test: To confirm if the PSA level remains elevated over time.

Digital Rectal Exam (DRE): A physical examination where the doctor checks the prostate for abnormalities.

Prostate Biopsy: A small sample of prostate tissue is taken for examination to confirm if cancer is present.

Imaging Tests: Such as ultrasound, MRI, or CT scans, to assess the prostate and surrounding areas.

While PSA testing can be helpful, it has some limitations:

False Positives: A high PSA level can be caused by conditions other than cancer, leading to unnecessary anxiety and additional testing.

False Negatives: Prostate cancer can still be present even with normal PSA levels, especially in its early stages.