Prostate cancer is the 2nd most diagnosed cancer in adult males.
The PSA test is a screening exam capable of detecting prostate cancer.
Other than cancer, a PSA test can indicate inflamed or enlarged prostate (benign prostatic hyperplasia).
Small PSA level circulates the blood. So, even if a PSA test shows high scores, it doesn’t mean it is cancer.
Based on reports, 86% of patients with BPH (benign prostatic hyperplasia) have an increased serum PSA. This means that the score on your PSA test can be complicated.
If you are interested in the ins and outs of this specific antigen, baseline PSA, and its impact on cancer screening, then you’ve come to the right place.
We will answer all your PSA-level-related queries.
Normal Age Specific PSA Levels
There are plenty of concerns when it comes to specific antigen testing and PSA level. A PSA test is met with controversy.
That’s mainly because this screening and PSA level can alert doctors of prostate cancer presence. But, it won’t offer precise information that would definitely determine whether the patient has cancer.
The shift emerges from the growing evidence that the harms of a PSA test outweigh the potential for benefits. Unnecessary prostate biopsies can lead to some side effects like impotence and incontinence.
If the serum PSA is too high, then these PSA level readings can also take a physical and emotional toll on men.
The PSA test results can lead to overdiagnosis and overtreatment. To better understand PSA screening, or prostate cancer screening, take a look at the age specific reference range below. Here you can see the normal PSA levels by age so that you can recognize elevated PSA.
Decoding age specific PSA
| Age group | Normal PSA level (ng/mL) |
| All age specific ranges | <4.0 |
| 40 to 49 | <2.5 |
| 50 to 59 | <3.5 |
| 60 to 69 | <4.5 |
| >70 | <6.5 |
What This Means
In the case of a serum PSA value greater than 4 ng/mL, as seen in the age specific reference, serum PSA detection rates for cancer of the prostate reach a specificity of 91%.
A digital rectal examination is also a viable option for cancer testing. When you compare it with a digital rectal examination, a PSA test is more specific. That’s because digital rectal examination (DRE) has a specificity of 59%.
That’s why a PSA screening or PSA level has the potential to spot early prostate cancer. It could be used with the intent to avoid cancer disease progression and curb cancer mortality. But, with regular PSA screening, many patients can increase the morbidity. In general, PSA sensitivity ranges from 9% to 33% based on age.
And, as many as 91% of individuals with high PSA levels don’t have prostate cancer. But, when it comes to increasing serum PSA that does prove to be cancerous, most low-risk prostate cancer can be managed with active surveillance and monitoring. Only around 25% of men who use active surveillance will experience cancer progression and require active prostate cancer treatment.
What Age Should You Get a PSA Test?
Some patients with high prostate cancer risk have no idea when is the right time for a screening. They want to boost their odds of successful cancer treatment with early prostate cancer detection and management strategies.
The general starting age for specific antigen testing starts at 55 years, but some younger patients can get the serum PSA testing.
Overall, anyone under 40 is recommended to steer clear of the specific antigen test. The spike in serum PSA could be caused by other health issues and trigger a false positive.
For those between 40 and 54 years, there is often no need for routine screening or a PSA test. Unless they are at high risk of getting prostate cancer or any other cancer.
The greatest benefit of screening is best meant for those between 55 and 69 years. To curb the potential for screening side effects, the test interval of 2 years can be a better alternative than yearly screening. For those over 70, doctors don’t often recommend a specific antigen test.
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Understanding What Your PSA Level Indicates
PSA velocity or a change in total PSA can happen in any age group. PSA velocity with rapid rise is often seen as dangerous. So, analyzing the PSA velocity and total PSA during cancer screening is important.
A PSA level that’s well beyond 4.0 ng/mL is seen as suspicious. But, many factors come into play with the elevated PSA.
Serum PSA level could rise with old age. Elevated PSA can also happen from having a recent biopsy, catheter, prostatitis, or a urinary tract infection.
Having had sex in the last 24 hours before taking the specific antigen can affect the serum PSA level. Prostate injury or pelvic injury, testosterone supplements, and riding a bicycle can produce similar results. So, discuss your screening with an expert.
General serum PSA level guidelines
- 10.0 ng/mL or more – This means that the total PSA results are dangerous. There is a 50% chance you have prostate cancer.
- 4.0 to 10.0 ng/mL – This prostate specific antigen reading indicates a possibility for cancer of the prostate. There is a 25% chance you could be having prostate cancer.
- 2.6 to 4 ng/mL – This prostate specific antigen reading is seen as relatively safe. But, consult with a doctor about the probable risk factors of the results of the PSA testing. Like prostatic hyperplasia.
- 0 to 2.5 ng/mL – This is seen as safe for any age group. Meaning that you are very unlikely to have prostate cancer.
How to Compare an Age Specific PSA Test Result
Interpreting the results of a PSA test can be complex. So, the readings of your PSA testing or cancer screening are better left in the hands of a doctor.
Conclusion
A prostate cancer diagnosis is a complex process. Sometimes the PSA density from specific antigen testing can help spot the problem. But, that doesn’t mean that the high PSA on specific antigen reading means you have prostate cancer.
On the contrary, the complex PSA can be difficult to articulate. So, leave the PSA level readings to the professionals.
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