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Prostate Specific Antigen Testing

What Men Need to Know About Prostate Specific Antigen (PSA)

As men age, it’s likely their doctors will ask them to undergo a few more tests during their routine checkups than they’re accustomed to. One of those tests might involve the prostate-specific antigen, or PSA, blood screening. This simple procedure isn’t always recommended, but when it is it can provide physicians with a great deal of information about a patient’s prostate health. It can also prove to be a lifesaver if prostate cancer is detected.

About PSA Testing

The PSA test is designed to gauge the level of prostate-specific antigen proteins in a man’s blood. This protein is produced naturally in the prostate gland. At certain levels, PSA is considered perfectly normal. Elevated levels, however, may indicate a medical concern, such as inflammation in the prostate or the presence of prostate cancer.

Undergoing the test is relatively painless. It involves only a simple blood draw that is then sent to a laboratory for analysis. If high levels are detected, it’s not necessarily a cause for panic. Elevations in PSA may also be caused by urinary tract infections, prostatitis and benign prostatic hyperplasia, among other concerns. Should elevated levels be detected, follow-up tests to pinpoint the cause may be ordered and repeat PSA procedures may also be suggested to track levels for continued increases.

When is PSA Testing Suggested?

Screening recommendations recently changed for the PSA, taking the procedure off the table of routine tests for men who are at low risk of developing prostate cancer. Even so, some doctors continue to recommend its use for men starting around the age of 50 because of the insights it offers. Men who are at higher risk, such as those of African-American descent and men with a family history of cancer will find the recommendation is to begin PSA testing around the age of 40.

PSA testing recommendations changed because of the number of false positives the test produces. After all, elevated PSA levels can have many other causes. Even so, many doctors value the insights offered by the PSA and fear some men may now be suffering from undetected prostate cancer as a result of recommendation changes.  This concern has led some physicians to continue recommending this test as a way to screen for prostate cancer early.

Elevated PSA: What Does it Mean?

While there isn’t a specific magic number to indicate an elevated PSA, the normal level is typically about 4.0 ng/mL or lower. When a test comes back with results above this threshold, a doctor may recommend screening for concerns such as urinary tract infections. In many cases, a single elevated PSA will result in follow-up PSAs to track elevation levels. Should the numbers continue to rise, an X-ray, cystoscopy or ultrasound may be ordered. In some cases, a prostate biopsy might be indicated. Since biopsies come with their share of risks, such as infection, bleeding and pain, most doctors will recommend this as a last resort when suspicion of prostate cancer is especially high.

Is PSA Testing Worth It?

The PSA isn’t without its share of problems, but it remains the gold standard for helping detect prostate cancer in its earliest, most treatable forms. With that in mind, many doctors do still recommend this test and men can request it, as well. It is important, however, that men discuss this screening procedure and its results carefully with their healthcare providers so they can make informed decisions on how best to proceed.