If you’re over the age of 50, there is a good chance your doctor has recommended PSA testing along with a digital rectal exam to check for prostate cancer. This screening test is used to screen for prostate cancer, which is the most common type of cancer in men, and it can also be used to monitor a man’s progress after surgery or radiation therapy. A rise in a man’s PSA level may be the first sign of prostate cancer recurrence. This type of recurrence is typically much slower than the initial diagnosis of cancer, and it can often be detected by the patient himself before it causes any symptoms.
Most experts agree that men should start screening with a PSA blood test at age 50 if they have an average or above-average risk of the disease, and should stop around age 70. The PSA blood test measures a protein in the blood that’s produced by the prostate. Prostate-specific antigen levels naturally increase with age, and some studies suggest that the levels of prostate cancer patients rise more quickly than those of non-cancer patients.
PSA is measured in nanograms per milliliter of blood (ng/mL). The normal range varies from person to person, and it also changes with age. A PSA level below 2.5 ng/mL is usually considered normal. In most cases, a higher reading is not a sign of cancer, but the Cleveland Clinic notes that a PSA level of 4.0 ng/mL can be an indicator of prostate problems and that you should talk to your doctor about it.
In some cases, a man’s PSA levels can be raised by other things that aren’t related to prostate cancer, such as ejaculating within 24 hours of the test, urinary tract infections, or having a prostate biopsy. A doctor will consider all of these factors when evaluating a PSA test result.
Some researchers are working on a test that takes a PSA and measures its velocity, which can be a more accurate way to detect cancer. But there are no definitive guidelines that say whether or not men should get a PSA velocity test, and the U.S. Preventive Services Task Force has not endorsed it as a tool for prostate cancer screening.
A PSA velocity test is not yet widely available, and it can be expensive. The American Cancer Society recommends that doctors should discuss the pros and cons of the test with their patients, considering age, family history, and other health conditions, and personal preferences.
The information in this article was adapted from the National Comprehensive Cancer Network Guidelines for Prostate Cancer Early Detection and the accompanying chart “PSA Levels by Age.” Talk to your doctor about the benefits and risks of PSA screening before making a decision about your own personal risk. This is especially important if you have a family history of cancer or other health issues that put you at a greater risk for prostate cancer than other men your age.
