A healthy result should fall into the range 0 - 4 ng/mL.
Prostate-specific antigen (PSA) is one of the proteins that the prostate gland makes. Cancerous cells of the prostate also create these proteins. The purpose of the PSA test is to identify that the prostate gland is stressed and may have significant disease.
High PSA levels are not necessarily correlated with cancer. They may mean that there is a urinary tract infection or the prostate is simply inflamed. According to the National Cancer Institute, “there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men in any racial or ethnic group.”
What is a normal PSA test result?
There is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. In the past, most doctors considered PSA levels of 4.0 ng/mL and lower as normal. Therefore, if a man had a PSA level above 4.0 ng/mL, doctors would often recommend a prostate biopsy to determine whether prostate cancer was present.
However, more recent studies have shown that some men with PSA levels below 4.0 ng/mL have prostate cancer and that many men with higher levels do not have prostate cancer.
In addition, various factors can cause a man’s PSA level to fluctuate. For example, a man’s PSA level often rises if he has prostatitis or a urinary tract infection. Prostate biopsies and prostate surgery also increase PSA level. Conversely, some drugs—including finasteride and dutasteride, which are used to treat BPH—lower a man’s PSA level. PSA level may also vary somewhat across testing laboratories.
Another complicating factor is that studies to establish the normal range of PSA levels have been conducted primarily in populations of white men. Although expert opinions vary, there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men of any racial or ethnic group.
In general, however, the higher a man’s PSA level, the more likely it is that he has prostate cancer. Moreover, a continuous rise in a man’s PSA level over time may also be a sign of prostate cancer.
Low levels of PSA are not a health problem.
If levels are high, other tests may be ordered to decide where the health issue is originating. For example, a urine test, x-rays, prostate biopsy, transrectal ultrasound or cystoscopy may be ordered.
The PSA test is known for its false-positive or false-negative results. According to the National Cancer Institute, only about 25% of men who have a prostate biopsy because their PSA level was high actually have prostate cancer.
Some specific causes of high PSA levels could include:
- Urinary tract infection
- Prostate cancer
- Prostate inflammation
- Enlarged prostate
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