Prostate Restored
Prostate Restored
Photo: Oziel Gómez
A PSA level that is above 3.0 ng/mL is considered suspicious. However, PSA levels can rise as you get older. For men over age 75, a PSA below 4.0 ng/mL is considered normal. You and your doctor should consult age-specific PSA ranges and recommendations.
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Read More »The latest NCCN recommendations are covered above in the Prostate Cancer Early Detection: Age Recommendations and PSA Levels Chart. In 2012, the U.S. Preventive Services Task Force (USPSTF) assigned the PSA test a “D” rating. This meant that the USPSTF concluded the harms that resulted from PSA testing, such as unnecessary biopsies and negative treatment side effects, outweighed the benefits of finding and managing the disease early. This recommendation did not include exceptions for men at increased risk of developing the disease, such as Black or African American men, those with a family history of the disease, and those with BRCA gene mutations. The USPSTF recommendation is important as it guides primary care physicians in preventive care and can impact insurance coverage and reimbursement for screening. Prior to its “D” rating, the PSA test had an “I” rating, meaning the USPSTF concluded there was insufficient evidence to assess the pros and cons of testing. In 2018, the USPSTF updated their recommendation on PSA screening, assigning the PSA test a “C” rating for men ages 55 to 69 (the test still has a “D” rating for men ages 70+). This was in response to research demonstrating the benefits of PSA screening (such as the European Randomized Study of Screening for Prostate Cancer), an increase in the number of men choosing active surveillance, and advocacy efforts. This means that the USPSTF recognizes a small potential benefit of PSA testing and recommends that men make individual decisions about whether or not to get tested after discussing the risks and benefits with their doctors. Like the 2012 recommendation, this update does not include specific language for men at increased risk. The National Comprehensive Cancer Network® (NCCN) and ZERO strongly recommend that men should be fully educated about prostate cancer, should know their options for early detection, and should have access to the tests we have available now. Researchers, with support from organizations like ZERO, are working every day to improve prostate cancer screening, but for now, we must use the tools we have. A PSA test score is an important part of making a decision on how best to determine a prostate cancer diagnosis and/or treatment pathway. Visit our advocacy site to learn about ZERO’s advocacy efforts in early detection and access to PSA screening.
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Besides cancer, other conditions that can raise PSA levels include an enlarged prostate (also known as benign prostatic hyperplasia or BPH ) and an...
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Learn More »There is no specific normal or abnormal level of PSA in the blood. In the past, PSA levels of 4.0 ng/mL and lower were considered normal. However, some individuals with PSA levels below 4.0 ng/mL have prostate cancer and many with higher PSA levels between 4 and 10 ng/mL do not have prostate cancer (1).
Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in the blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter (ng/mL) of blood. The blood level of PSA is often elevated in people with prostate cancer, and the PSA test was originally approved by the FDA in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, FDA approved the PSA test to be used in conjunction with a digital rectal exam (DRE) to aid in the detection of prostate cancer in men 50 years and older. Until about 2008, many doctors and professional organizations had encouraged yearly PSA screening for prostate cancer beginning at age 50. PSA testing (along with a DRE) is also often used by health care providers for individuals who report prostate symptoms to help determine the nature of the problem. In addition to prostate cancer, several benign (not cancerous) conditions can cause a person’s PSA level to rise, particularly prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (BPH) (enlargement of the prostate). There is no evidence that either condition leads to prostate cancer, but someone can have one or both of these conditions and develop prostate cancer as well.
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