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There are two primary means of screening for prostate cancer.  Along with the digital rectal exam (or DRE), in which a physician inserts a gloved finger into the rectum to examine the prostate for irregularities, a PSA test is the leading method of screening for prostate cancer. A PSA test can help catch the disease at an early stage when treatment is thought to be more effective and potentially has fewer side effects.

What does PSA Mean?

PSA, or prostate specific antigen, is a protein produced by the prostate and found mostly in semen, with very small amounts released into the bloodstream. When there’s a problem with the prostate—such as the development and growth of prostate cancer—more PSA is released. Sometimes, a man’s prostate releases slightly high PSA for other reasons.  Rising PSA eventually reaches a level where it can be easily detected by a blood test.

For more information on rising PSA, download or order your free copy of the Prostate Cancer Patient Guide.

What is the PSA Test?

During a PSA test, a small amount of blood is drawn from the arm, and the level of PSA, a protein produced by the prostate (not prostrate), is measured. Normal PSA ranges can vary according to factors unique to each man, so the PSA test is just a part of the process of screening for prostate cancer.

Doctors look at the overall PSA numbers, as well as the rate at which it rises over time and repeated tests (velocity). As the PSA number goes up, the chance that cancer is present increases. Depending on their age, men whose levels go above 3 or 4 are often recommended to undergo a biopsy; however, this PSA level does not mean that prostate cancer is definitely there, and some cancers can be present even when PSA levels are lower.

In general, older men’s normal PSA levels run a little higher than those of younger men. Normal levels tend to vary a little between different ethnic groups, but in general, see this PSA chart:

If you are in your … Your normal PSA range should be …
40s 0–2.5 ng/mL
50s 0–4 ng/mL
60s 0–4.5 ng/mL
70s 0–6.5 ng/mL

What is a high PSA level and what is a normal PSA level vary by demographic factors. Your doctor will evaluate your test results, factor in your age, ethnicity, and any other relevant factors, and let you know whether your results suggest more testing.

Remember that assessment of PSA must also take into account:

  • Prostate size: A man with a larger-than-usual prostate may have a higher-than-usual normal PSA level.
  • Prostatitis: Prostatitis is a painful condition, often caused by bacterial infection in which the prostate is inflamed, swollen, and tender. Prostatitis can cause high PSA.
  • Benign prostatic hyperplasia (BPH): BPH is an enlarged prostate. It may make urination or ejaculation difficult, and along with the swelling, may cause a spike in PSA levels.
  • Urinary tract infection or irritation: An infection of the urinary tract, as well as irritation caused by medical procedures involving the urethra or bladder, may irritate the prostate and cause it to produce more PSA.
  • Prostate stimulation: Sexual activity (or even a DRE) can cause temporarily high PSA.
  • Medications: Some medications, such as finasteride (Proscar or Propecia) or dutasteride (Avodart), can cause low PSA numbers.

Each time you see your doctor for a checkup, have a conversation about prostate health and prostate cancer screening. PSA levels can be influenced by many different factors—it’s just one piece of the puzzle.

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