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Results
By Mayo Clinic staffResults of PSA tests are reported as nanograms of PSA per milliliter of blood (ng/mL). A PSA result of 4.0 ng/mL has generally been considered the cut-off point. Therefore, if you have a PSA of 4.0 or higher, your doctor may recommend a biopsy to determine if there's any cancerous tissue.
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.
There's little clinical evidence — as with standard PSA tests — that these variations on the PSA screening test improve treatment outcomes or decrease the number of deaths. Researchers continue investigating these strategies to determine if 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.
- Age-adjusted PSA. Age-adjusted PSA is an adjustment of the cut-off point for recommending a biopsy. Because PSA levels increase with age, it may be appropriate to lower the cut-off for younger men and raise it for older men.
- 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 are your options 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.
- Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine. 2008;149:185.
- Overview: Prostate cancer. How many men get prostate cancer? American Cancer Society. http://www.cancer.org/docroot/CRI/content/CRI_2_2_1X_How_many_men_get_prostate_cancer_36.asp?sitearea=. Accessed Feb. 16, 2009.
- The prostate-specific antigen (PSA) test: Questions and answers. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/detection/PSA. Accessed Feb. 12, 2009.
- What You Need to Know About Prostate Cancer. Rockville, Md.: National Cancer Institute; 2008.
- Can prostate cancer be found early? American Cancer Society. http://www.cancer.org/docroot/cri/content/cri_2_4_3x_can_prostate_cancer_be_found_early_36.asp. Accessed Feb. 12, 2009.
- Lin K, et al. Benefits and harms of prostate-specific antigen screening for prostate cancer: An evidence update for the U.S. Preventive Services Task Force. Annals of Internal Medicine. 2008;149:192.
- Prostate cancer: Screening. Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/prostate/basic_info/screening.htm. Accessed Feb. 15, 2009.
- Ferrini R, et al. Screening for prostate cancer in American men: American College of Preventive Medicine Practice Policy Statement. American College of Preventive Medicine. http://www.acpm.org/prostate.htm. Accessed Feb. 15, 2009.
- Early detection of prostate cancer. American Urological Association. http://www.auanet.org/content/guidelines-and-quality-care/policy-statements/e/early-detection-of-prostate-cancer.cfm. Accessed Feb. 16, 2009.
- Andriole GL, et al. Mortality results from a randomized prostate-cancer screening trial. New England Journal of Medicine. 2009;360:1310.
- Schroder FH, et al. Screening and prostate-cancer mortality in a randomized European study. New England Journal of Medicine. 2009;360:1320.
- Carroll P, et al. Prostate-specific antigen best practice statement: 2009 update. American Urological Association. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/psa09.pdf. Accessed April 28, 2009.
