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Prostate-Specific Antigen (PSA)

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

  • Recent sexual activity (ejaculation).
  • Recent use of a tube (catheter) to drain urine or a cystoscopy.
  • Recent urinary tract infection (UTI) or prostatitis.
  • Recent digital rectal exam, prostate biopsy, or prostate surgery.
  • Large doses of medicines, such as cyclophosphamide (Cytoxan) and methotrexate for cancer treatment.
  • The medicines finasteride (Proscar) and dutasteride (Avodart), which are used to prevent further enlargement of the prostate gland in men with BPH.

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.
  • 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.

Citations

  1. Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.

  2. Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.

Other Works Consulted

  • Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.

  • Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.

  • Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.

  • U.S. Preventive Services Task Force (2012). Screening for Prostate Cancer: Recommendation Statement. Available online: http://www.uspreventiveservicestaskforce.org/prostatecancerscreening/prostatefinalrs.htm.

WebMD Medical Reference from Healthwise

Last Updated: January 30, 2014
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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