Blog
PSA (prostate-specific antigen): a key test for assessing prostate health
What is PSA and why is it measured?
PSA is a protein produced by prostate cells. Normally, small amounts of it circulate in the blood. Elevated PSA levels may indicate pathological changes in the prostate: inflammation (prostatitis), benign hyperplasia, or malignant formation.
In accordance with Mayo Clinic, the PSA test is used as a screening method to detect prostate cancer in its early stages, when symptoms are not yet present.
Who is recommended to take PSA?
men over 45 years old - every year
individuals with a strong family history (prostate cancer in relatives)
patients with urinary incontinence
after prostate cancer treatment (to control recurrence)
on the recommendation of a urologist in case of suspected benign hyperplasia
Types of PSA and their diagnostic significance
| PSA type | Explanation | Diagnostic role |
|---|---|---|
| General (Total PSA) | Total PSA in the blood | Basic prostate marker |
| Free (Free PSA) | PSA not bound to blood proteins | Clarification of the nature of the process |
| Free/Total ratio | Percentage | Below 10–15% — increased cancer risk |
PSA norm depending on age
| Age group | PSA (ng/ml) |
|---|---|
| Up to 50 years old | up to 2.5 |
| 50–59 years old | up to 3.5 |
| 60–69 years old | up to 4.5 |
| 70+ years | up to 6.5 |
As noted WHO, an increase in PSA above 4 ng/ml is a reason for further examination, but does not always mean cancer. Additionally, dynamics, symptoms, ultrasound results and biopsy are taken into account.
What can affect PSA levels?
inflammatory processes (prostatitis)
benign prostatic hyperplasia
ejaculation within 48 hours before taking the test
prostate massage or transrectal ultrasound
physical activity, including cycling
Tips for preparing for analysis
abstain from sex for 48 hours before blood collection
avoid any pressure on the prostate area (biking, catheters)
do not undergo a prostate exam 3–5 days before the test
donate blood on an empty stomach, in the morning
How to interpret PSA results
| PSA level | Possible values | Actions |
|---|---|---|
| Up to 2.5 ng/ml | Norm | Annual observation |
| 2.5–4.0 ng/ml | Probable benign pathology | Observation, analysis of Free PSA |
| 4.0–10.0 ng/ml | Average risk of cancer | Biopsy, MRI of the prostate |
| Above 10 ng/ml | High risk | Immediate consultation with an oncologist |
Additional use of PSA after treatment
After radical treatment of prostate cancer, PSA levels should decrease to minimal values (<0.1 ng/mL). An increase in dynamics is considered a possible marker of recurrence. As noted FDA, PSA remains an important surveillance tool in postoperative patients.
PSA analysis is one of the most important screening methods in male urology. It helps to detect serious pathologies in time and prevent complications if used regularly and with correct interpretation of the results.
