PSA Testing: The First Step in Prostate Cancer Screening
Total prostate-specific antigen (PSA) test is a blood test used as the first step in prostate cancer screening.
However, PSA is not cancer-specific, and PSA testing alone cannot differentiate between aggressive prostate cancer, indolent cancer, or other benign prostate conditions.
What is PSA?
PSA (prostate-specific antigen) is a group of proteins produced by the prostate gland. A PSA test is a blood test that measures the total amount of PSA in your blood. Changes in PSA levels may be associated with a variety of prostate conditions.
Why Is a PSA Test Performed?
PSA is commonly used as an initial screening tool for prostate cancer. Your healthcare provider may recommend a PSA test as part of a routine prostate health evaluation, particularly if you are age 45 or older, have urinary symptoms, or have other factors that may increase your risk of prostate cancer.
Although PSA testing provides important information, it is only one piece of the overall picture. Your healthcare provider will consider your PSA result along with other clinical information when making recommendations about your care.
What Can Cause an Elevated PSA?
An elevated PSA result does not necessarily mean prostate cancer is present. PSA levels can be elevated for a variety of non-cancerous reasons, including:
- Benign prostate enlargement (also known as benign prostatic hyperplasia, or BPH)
- Prostate inflammation or infection (prostatitis)
- Recent vigorous activity, such as cycling
- Recent procedures involving the prostate, such as a prostate biopsy or prostate surgery
Because many non-cancerous conditions can raise PSA levels, additional evaluation is often needed to better understand what an elevated result may mean.
What PSA Can—and Cannot—Tell You
A PSA test is an important first step, but it has limitations.
A PSA test can:
- Identify changes in prostate health that may require additional evaluation.
- Help your healthcare provider monitor your PSA levels over time.
- Provide information that helps determine whether further testing may be appropriate.
A PSA test cannot:
- Diagnose prostate cancer.
- Distinguish between aggressive prostate cancer, slow-growing (indolent) prostate cancer, and non-cancerous prostate conditions.
- Determine on its own whether a prostate biopsy is necessary.
PSA Is a Starting Point
An elevated PSA is a starting point—not a diagnosis. If your PSA is elevated, your healthcare provider may recommend additional evaluation to better understand what the result means for you.
Additional testing may include imaging or biomarker tests, such as the FDA-approved 4Kscore® Test, which provides information about the likelihood of finding aggressive prostate cancer on biopsy. This added information can help you and your healthcare provider make a more informed decision about how to proceed with your care.