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Prostate Specific Antigen Testing

Information About Prostate Specific Antigen (PSA)

Men who keep up with regular health screenings are likely to find a new blood test added to the routine as they age. The prostate-specific antigen, or PSA, test can tell doctors a great deal about the condition of a man’s prostate gland while also offering insights about the potential presence of cancer.

Understanding PSA Testing

Prostate-specific antigen is a protein that is produced within the cells of the prostate gland itself. The test for this protein measures the levels found in a man’s body. The test involves only a simple blood draw and an analysis conducted in a laboratory.

PSA is normally occurring in men, but high levels can indicate concerns. PSA tests, for example, are used as an early screening marker for prostate cancer. Especially elevated results may lead to additional testing. While prostate cancer does present with elevated PSA results, other conditions may also create a spike in numbers. Inflammation of the prostate caused by prostatitis and benign prostatic hyperplasia, or enlargement of the prostate, can also create high readings. When readings are elevated, doctors may order follow-up tests to confirm or rule out a diagnosis of prostate cancer.

PSA Guidelines

Until rather recently, most doctors recommended men begin undergoing annual PSA screening about the age of 50. Earlier screening was recommended for men at higher risk for prostate cancer, such as those of African-American descent or men with a family history of the disease. Recent screening recommendation changes, however, have lessened the reliance on this test for screening. While false-positives are possible with the PSA, some doctors still value the insights it offers and fear men are now going with prostate cancer undiagnosed as a result of recommendation changes. This concern has led some healthcare providers to continue to use the PSA in their practices.

What Does an Elevated PSA Mean?

There is no hard and fast rule for normal or abnormal levels of PSA in a man’s blood. Typically, a PSA level of 4.0 ng/mL or lower is used as the marker for a normal range. Men with elevated PSA numbers beyond the 4.0 ng/mL mark may find their healthcare providers recommending a few other tests to rule out different possible causes for the elevation. A urine test, for example, may be requested to rule out a urinary tract infection. A doctor may also order X-rays, a cystoscopy or ultrasound.  Repeat PSA testing may also be recommended to track levels.

In cases where PSA level is high and remains consistently so or continues to elevate a biopsy may be ordered. This test does come with its share of potential risks, including infection, bleeding and pain. Many doctors will track PSA levels for a time and go to great lengths to rule out other causes for the elevation before ordering a biopsy to help patients avoid potential risks associated with the procedure.

Is PSA Testing Worth It?

For years, the PSA test was used as the gold standard for early prostate cancer screening. While imperfections in the test led to recommendation changes, many doctors still value this tool when used in conjunction with other screening measures, such as a digital rectal exam. Men should discuss the PSA with their healthcare providers so they can make informed decisions about the value this screening tool may provide. Early detection of prostate cancer can prove to be a lifesaver for many men.

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