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The PSA test is a blood test used primarily to screen for prostate cancer.
The test measures the amount of prostate-specific antigen (PSA) in your blood. PSA is a protein produced by both cancerous and noncancerous tissue in the prostate, a small gland that sits below the bladder in men.
PSA is mostly found in semen, which also is produced in the prostate. Small amounts of PSA ordinarily circulate in the blood.
The PSA test can detect high levels of PSA that may indicate the presence of prostate cancer. However, many other conditions, such as an enlarged or inflamed prostate, can also increase PSA levels. Therefore, determining what a high PSA score means can be complicated.
There is a lot of conflicting advice about PSA testing. To decide whether to have a PSA test, discuss the issue with your doctor, considering your risk factors and weighing your personal preferences.
Prostate cancer is common, and a frequent cause of cancer death. Early detection may be an important tool in getting appropriate and timely treatment.
Men with prostate cancer may have elevated levels of PSA. However, many noncancerous conditions also can increase the PSA level. The PSA test can detect high levels of PSA in the blood but doesn't provide precise diagnostic information about the condition of the prostate.
The PSA test is only one tool used to screen for early signs of prostate cancer. Another common screening test, usually done in addition to a PSA test, is a digital rectal exam.
In this test, your doctor inserts a lubricated, gloved finger into your rectum to reach the prostate. By feeling or pressing on the prostate, the doctor may be able to judge whether it has abnormal lumps or hard areas.
Neither the PSA test nor the digital rectal exam provides enough information for your doctor to diagnose prostate cancer. Abnormal results in these tests may lead your doctor to recommend a prostate biopsy.
During this procedure, samples of tissue are removed for laboratory examination. A diagnosis of cancer is based on the biopsy results.
For men who have already been diagnosed with prostate cancer, the PSA test may be used to:
Professional organizations vary in their recommendations about who should — and who shouldn't — get a PSA screening test. Discussing with your doctor the benefits, limitations and potential risks of the PSA test can help you make an informed decision.
A PSA test may help detect prostate cancer at an early stage. Cancer is easier to treat and is more likely to be cured if it's diagnosed in its early stages.
But to judge the benefit of the test, it's important to know if early detection and early treatment will improve treatment outcomes and decrease the number of deaths from prostate cancer.
A key issue is the typical course of prostate cancer. Prostate cancer usually progresses slowly over many years. Therefore, a man may have prostate cancer that never causes symptoms or becomes a medical problem during his lifetime.
The limitations of PSA testing include:
The potential risks of the PSA test are essentially related to the choices you make based on the test results, such as the decision to undergo further testing and treatment for prostate cancer. The risks include:
A nurse or medical technician will use a needle to draw blood from a vein, most likely in your arm. The blood sample is then analyzed in the lab to measure your PSA level.
Results 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.
Your doctor might use other ways of interpreting PSA results before deciding whether to order a biopsy to test for cancerous tissue. These other methods are intended to improve the accuracy of the PSA test as a screening tool.
Researchers continue to investigate variations of the PSA test to determine whether they provide a measurable benefit.
Variations of the PSA test include:
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:
Discussing these issues beforehand may make it easier for you to learn the results of your test and make appropriate decisions afterward.
Last Updated May 4, 2019