PSA
HormonesAlso known as: prostate-specific antigen, prostate specific antigen
A protein produced primarily by prostate cells, measured to screen for prostate abnormalities including cancer.
While elevated levels (typically >4 ng/mL) may indicate prostate cancer, they can also result from benign conditions like prostate enlargement (BPH), inflammation (prostatitis), or recent ejaculation. PSA levels tend to naturally increase with age. In your health assessment, we cross reference PSA with MR images.
Why this matters
PSA levels reveal early changes in prostate health before symptoms like urinary difficulties or pain appear. Elevated PSA can indicate prostate enlargement, inflammation, or prostate cancer. Regular PSA testing and follow-up with a healthcare provider help detect issues early and guide appropriate management to maintain prostate health.
How this connects to other biomarkers
- Elevated PSA in men > 50 warrants evaluation for prostate cancer, benign prostate enlargement, or prostatitis (prostate inflammation) — review PSA density (PSA divided by prostate volume on imaging) and free/total ratio for risk stratification.
- A rising PSA velocity (> 0.75 ng/mL per year) is more concerning than the absolute level and prompts urology referral.
- PSA can be falsely elevated by recent ejaculation, prostate exam, urinary infection, or vigorous cycling.
How often should I test PSA?
PSA screening is typically discussed with a clinician starting from age 50, or from 45 if you have a family history of prostate cancer or African ancestry. For most men, yearly or every-other-year testing is standard. After a urological procedure or treatment, your urologist guides the cadence, typically every 3 to 6 months initially.
At baseline / for screening: Once every 12 to 24 months from age 50, in discussion with your clinician about the screening benefits and limitations. From age 45 if you have a family history of prostate cancer or African ancestry.
When monitoring an intervention or change: Retest 3 to 6 months after a urological procedure or treatment (biopsy, surgery, radiation, hormone therapy) to track response. PSA rises transiently with recent ejaculation (within 48 hours), prostate exam, cycling, or urinary tract infection, so standardize conditions for reliable trend tracking. Single elevations often warrant a repeat before further investigation.
Note: Wait 48 to 72 hours after ejaculation, prostate exam, cycling, or urinary tract infection before testing, since all transiently elevate PSA. For biochemical recurrence monitoring after prostate cancer treatment, your urologist sets a 3-monthly interval initially.
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