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Results
By Mayo Clinic staffResults of PSA tests are reported as nanograms of PSA per milliliter of blood (ng/mL). There's no specific cutoff point between a normal and abnormal PSA level. Your doctor might recommend a prostate biopsy based on results of your PSA test and a digital rectal exam, along with other factors.
Variations of the PSA test
Your doctor may use other ways of interpreting PSA results before making decisions about ordering a biopsy to test for cancerous tissue. These other methods are intended to improve the accuracy of the PSA test as a screening tool.
As with the standard PSA test, there's little clinical evidence that these variations on the PSA screening test improve treatment outcomes or decrease the number of deaths. Researchers continue investigating these strategies to determine whether they provide a measurable benefit. Variations of the PSA test include:
- PSA velocity. PSA velocity is the change in PSA levels over time. A rapid rise in PSA may indicate the presence of cancer or an aggressive form of cancer.
- Percentage of free PSA. PSA circulates in the blood in two forms — either attached to certain blood proteins or unattached (free). If you have a high PSA level but a low percentage of free PSA, it may be more likely that you have prostate cancer.
Talk to your doctor
Before getting a PSA test, talk to your doctor about the benefits and risks. If you decide that a PSA test is right for you, ask your doctor:
- When you will discuss the results
- What kinds of recommendations he or she might make if the results are positive
- How often you should repeat the test if the results are negative
Discussing these issues beforehand may make it easier for you to learn the results of your test and make appropriate decisions afterward.
- Prostate-specific antigen (PSA) test. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/detection/PSA. Accessed April 5, 2011.
- Prostate cancer: Early detection. American Cancer Society. http://www.cancer.org/Cancer/ProstateCancer/MoreInformation/ProstateCancerEarlyDetection/prostate-cancer-early-detection-pdf. Accessed April 5, 2011.
- Prostate cancer screening. Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/prostate/basic_info/screening.htm. Accessed April 5, 2011.
- Gjertson CK, et al. Use and assessment of PSA in prostate cancer. Medical Clinics of North America. 2011;95:191.
- Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Rockville, Md.: U.S. Preventive Services Task Force. http://www.uspreventiveservicestaskforce.org/draftrec3.htm#recd. Accessed Oct. 11, 2011.
- Prostate cancer overview. How many men get prostate cancer? American Cancer Society. http://www.cancer.org/Cancer/ProstateCancer/OverviewGuide/prostate-cancer-overview-key-statistics. Accessed April 5, 2011.
- What You Need to Know About Prostate Cancer. Rockville, Md.: National Cancer Institute; 2008. http://www.cancer.gov/cancertopics/wyntk/prostate/page1. Accessed April 8, 2011.
- Guideline synthesis: Screening for prostate cancer. National Guideline Clearinghouse. http://www.guideline.gov/syntheses/printView.aspx?id=16398. Accessed April 5, 2011.
- Shteynshlyuger A, et al. Prostate cancer: To screen or not to screen? Urologic Clinics of North America. 2010;37:1.
- Greene KL, et al. Prostate specific antigen best practice statement: 2009 update. The Journal of Urology. 2009;182:2232.
- AUA Foundation responds to American Cancer Society guideline for the early detection of prostate cancer. AUA Foundation. http://www.auanet.org/content/press/press_releases/article.cfm?articleNo=179. Accessed April 5, 2011.
- Wolf AMD, et al. American Cancer Society guideline for the early detection of prostate cancer. CA: A Cancer Journal for Clinicians. 2010;60:70.
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