PSAprostatarakoscreening

PSA testing refers to a blood test that measures the level of prostate-specific antigen (PSA), a protein produced by cells of the prostate gland. The test is used mainly to help detect prostate cancer and to monitor treatment or disease progression in men with known cancer. PSA is not cancer-specific, and elevated levels can occur for reasons other than cancer.

Elevated PSA levels can result from benign conditions such as benign prostatic hyperplasia (BPH), prostatitis, a urinary tract infection, recent ejaculation, vigorous bicycle riding, or recent prostate procedures. Because many noncancer factors influence PSA, a high value does not by itself prove that cancer is present, and a low PSA does not guarantee absence of cancer.

Interpreting PSA requires context. Clinicians consider the absolute level, the rate of change over time (PSA velocity), and, when possible, prostate volume to calculate PSA density. Age-specific reference ranges and risk calculators are sometimes used. A common threshold mentioned in older guidance is 4.0 ng/mL, but recommendations vary by age, race, and individual risk, and some guidelines favor more individualized decision-making rather than universal cutoffs.

Screening recommendations differ among organizations and may emphasize shared decision-making, particularly for men in the 55–69 age range or those with higher risk (such as family history or certain genetic factors). In some groups, routine screening for older men is not advised.

If PSA is elevated, doctors may repeat the test, assess for prostatitis, or proceed with imaging such as multiparametric MRI and possibly a prostate biopsy to determine the presence and extent of cancer. If cancer is confirmed, treatment options range from active surveillance for low-risk disease to surgery or radiotherapy, with decisions guided by cancer risk and patient preferences.