Prostate-specific antigen, or PSA, is a protein produced by the cells in the prostate gland. It is primarily known for its role in assessing the health of the prostate, particularly in the context of prostate cancer. Elevated levels of PSA can be a sign of various prostate conditions, including prostate cancer, benign prostatic hyperplasia (BPH), and prostatitis.

Who should take this test?

There is no one-size-fits-all recommendation for PSA testing, and guidelines have evolved over the years due to concerns about overdiagnosis and overtreatment of prostate cancer. Most medical organizations recommend that the decision to undergo PSA testing be individualized based on a person's age and risk factors.

For individuals at average risk for prostate cancer, discussions about PSA testing typically begin around age 50. Earlier screening may be appropriate for those at higher risk, including African Americans and individuals with a family history of prostate cancer.

For those who decide to undergo PSA testing, monitoring PSA levels over time (serial testing) can be more informative than a single test. Significant changes in PSA levels or a consistently elevated PSA may prompt further evaluation.

What is included in this test?

This blood test measures:

• Total PSA
• Free PSA (when total is between 4.0 and 10.0 ng/mL)

This test measures total PSA in the blood (both free PSA and PSA bound to other proteins). When the total PSA level is within a certain range, free PSA (PSA that is not bound to other proteins in the blood) is also measured. The ratio of these two forms of PSA can provide additional information about the likelihood of prostate cancer.

How will taking this test benefit me?

When interpreted alongside other clinical factors, the PSA test is a valuable tool to assist in making informed decisions about further diagnostic assessments, such as a prostate biopsy. Early detection of aggressive prostate cancer can lead to more effective treatment options, potentially increasing the chances of successful management.