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Prostate-Specific Antigen (PSA)

What To Think About

  • When combined with a digital rectal exam, the prostate-specific antigen (PSA) test may increase the chance of finding prostate cancer. To learn more, see the topic Digital Rectal Examination (DRE).
  • A PSA level within the normal ranges does not mean that prostate cancer is not present. Some men who have prostate cancer have normal PSA levels.
  • The American Cancer Society (ACS) advises men to talk with their doctors about testing and treatment before deciding about testing. The ACS says that men should not be tested without learning about the risks and benefits. The ACS advises talking to a doctor about testing:
    • At age 50 for men who are at average risk of getting prostate cancer and are expected to live at least 10 more years.
    • At age 45 for men at high risk, such as African Americans and men who have a first-degree relative (father, brother, or son) who had prostate cancer when he was younger than 65.
    • At age 40 for men at an even higher risk, such as those with several first-degree relatives who had prostate cancer at an early age.
  • The U.S. Preventive Services Task Force (USPSTF) recommends against routine PSA tests to look for prostate cancer. The USPSTF found that testing often does more harm than good. Men who are tested may end up getting treatment they don't need, and those treatments can cause other problems. Few, if any, men are helped to live longer by having the test.
  • The American Urological Association (AUA) recommends routine shared decision making only for men 55 to 69 years of age who are at average risk for prostate cancer and who don't have any symptoms of prostate cancer. The AUA says these men should talk with their doctors about the benefits and harms of PSA testing. Then they can decide based on their personal values and preferences.
  • Some experts do not advise yearly testing. They say the high rate of false-negative and false-positive results and the costs and risks of further tests outweigh the benefits of yearly screening tests.
  • Experts disagree about the type of testing that is appropriate if the PSA level is high. The decision may depend on:
    • Results of your digital rectal exam.
    • Results of any PSA tests you have had in the past. If your PSA level gets higher in a short amount of time, follow-up testing may be recommended.
    • Your age and health.
    • The costs and risks of more tests and treatments.
  • Other prostate tests are being evaluated to determine how well they tell the difference between prostate cancer and benign prostatic hyperplasia.
    • The prostate-specific antigen density (PSAD) test compares the PSA value to the size of the prostate gland. The size of the prostate is measured using transrectal ultrasound (TRUS).
    • The PSA velocity test is a measure of how rapidly PSA levels increase over time. PSA levels increase more rapidly in men with prostate cancer and more slowly in men with prostate enlargement (benign prostatic hyperplasia).
    • A complexed prostate-specific antigen (cPSA) test may help show if a prostate biopsy should be done. This test measures the amount of several forms of PSA that are attached to proteins found in the blood.

WebMD Medical Reference from Healthwise

Last Updated: May 14, 2013
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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