PSA Test

What is a PSA test?

A prostate-specific antigen (PSA) test measures the amount of PSA in your body. It’s a type of blood test that reveals if you have elevated PSA levels. PSA is a protein that your prostate gland makes. Normal and cancerous prostate tissue make PSA. But prostate cancer tends to produce PSA in higher amounts.

Healthcare providers recommend PSA tests for people assigned male at birth (AMAB) to screen for prostate cancer. Catching prostate cancer early with a PSA test increases your chances of effective treatment.

A provider will usually conduct a digital rectal exam (DRE) along with a PSA test.

What is a normal PSA by age?

A normal PSA depends on your age. Your PSA levels slowly increase as you get older, even if you don’t have prostate cancer or any other conditions that affect your prostate. Elevated PSA levels may indicate that you have prostate cancer.

Healthcare providers measure PSA in your blood in nanograms per milliliter of blood (ng/ml).

When is a PSA test performed?

PSA tests are very common. If you have a prostate, most healthcare providers recommend getting a PSA test every two to three years, starting around age 50.

If your PSA test results are abnormal, a provider may recommend close observation, with PSA tests and other screenings every six to 12 months.

If you have a high risk of prostate cancer, a provider may recommend getting regular PSA tests starting around 40. You may have a high risk of prostate cancer if you:

• Have a biological family history of prostate cancer (for example, your first-degree family members or two or more extended family members have prostate cancer).
• Are Black.

If you have prostate cancer, a provider may also recommend a PSA test to assess the effectiveness of your treatment or to make sure prostate cancer hasn’t come back.

What to expect before a PSA test

Before a PSA test, tell a healthcare provider if you:

• Are taking medications for benign prostatic hyperplasia (BPH), including finasteride (Proscar®) or dutasteride (Avodart®).
• Are taking finasteride (Propecia®) for hair loss.
• Had surgery to treat BPH, including transurethral resection (TUR).
• Had a prostate biopsy in the last six weeks.
• Recently used a urinary catheter or another procedure that affects your urinary system.
• Have a condition that affects your liver, such as cirrhosis of the liver, cystic fibrosis or hepatitis C.
• Currently have a urinary tract infection (UTI) or had one in the previous three months.

These medications and procedures can affect your PSA levels, which prevents a provider from getting an accurate reading.

A provider will give you directions a few days before your PSA test to help ensure you get the most accurate reading. These include:

• Don’t engage in any sexual activity 48 hours before your PSA test, including masturbation. Ejaculating may cause your PSA levels to rise temporarily.
• Don’t exercise 48 hours before your PSA test. Vigorous exercise — especially bicycling — can temporarily raise your PSA levels.

What to expect during a PSA test

A PSA test is a type of blood test. During a PSA blood test, a healthcare provider will:

• Disinfect the skin around a vein, usually in your arm.
• Use a thin needle to withdraw a small amount of blood from a vein.
• Send your blood sample to a lab for analysis.

How long does a PSA test take?

The blood draw for a PSA test usually takes only a few minutes. A healthcare provider may recommend resting for another few minutes before standing up and leaving.

What to expect after a PSA test

After the healthcare provider removes the needle, they’ll put clean cotton or gauze on the puncture wound and apply pressure to help stop any bleeding. They’ll then place a bandage on your skin.

Keep the bandage on for a few hours and keep it dry. You should also drink plenty of fluids and avoid exercising for a few hours after your blood test. Exercising after a blood draw puts you at an increased risk of:

• Fatigue.
• Dizziness.
• Fainting.
• Nausea and vomiting.
• Bleeding.
• Bruising.

What are the risks of a PSA test?

Risks or complications of a PSA test include:

• Other conditions besides prostate cancer may cause high PSA levels, including benign prostatic hyperplasia (BPH), prostate inflammation (prostatitis) and UTIs. These may raise concerns or cause the need for additional tests.
• Some types of prostate cancer don’t cause elevated PSA levels. You may have prostate cancer even if a PSA test says your levels are normal.
• You may feel nauseated, lightheaded or tired during or immediately after your blood draw.
• You may have pain or bruising at your needle injection site for a few days.

What type of results do you get, and what do the results mean?

PSA levels vary in range according to your age. If your PSA levels are higher than expected for your age range, it doesn’t mean that you have prostate cancer. But you might have a higher risk. Healthcare providers will order additional prostate cancer tests, which may include:

• Imaging tests. An MRI (magnetic resonance imaging) or a transrectal ultrasound can take detailed images of your prostate. If they reveal any suspicious areas, a provider may perform a biopsy.
• Prostate biopsy. During a prostate biopsy, a provider will remove a tissue sample from your prostate and test it for cancer. A prostate biopsy is the only way to diagnose prostate cancer and determine its stage.

When should I know the results of a PSA test?

You should get the results of your PSA test within a week. A healthcare provider may contact you to schedule a follow-up appointment to discuss your results.

What level of PSA indicates cancer?

Elevated PSA levels aren’t a guarantee you have prostate cancer. There’s no specific PSA level that indicates whether you have prostate cancer or not. The only way to know for sure that you have prostate cancer is to get a prostate biopsy.

A PSA level between 4 and 10 means you have over a 25% chance of having prostate cancer. If you have a PSA level greater than 10, you have over a 50% chance of having prostate cancer. It’s very important to talk to a healthcare provider about a prostate biopsy if your PSA is in these ranges.

When should I call my doctor?

Contact a healthcare provider about a PSA test if you have:

• A prostate and are 50 or older.
• An increased risk of prostate cancer. You have a higher risk of prostate cancer if you have a personal or family history of prostate cancer or you’re Black.
• Symptoms of prostate cancer.

What is an alarming PSA level?

PSA levels above 10 ng/ml typically indicate a higher risk of prostate cancer.

What are the symptoms of stage 1 prostate cancer?

The early stages of prostate cancer usually don’t have warning signs.

What are warning signs of prostate cancer?

As prostate cancer progresses, you may develop the following symptoms:

• Peeing changes. This may include urinary incontinence (including urge incontinence), a weak urine flow and pain or burning when you pee (dysuria).
• Pain in your lower back, hips or chest. This may indicate that prostate cancer has spread to other areas of your body.
• Blood in your pee or semen. Prostate cancer can affect areas of your urinary and reproductive systems, which can cause blood in your pee (hematuria) or semen (hematospermia).
• Bone pain. Advanced prostate cancer can spread to your bones and cause pain.
• Unexplained weight loss. Losing weight without trying can be a sign of cancer.
• Erectile dysfunction and painful ejaculation (dysorgasmia or orgasmalgia). Prostate cancer may affect your ability to get and maintain an erection. It may also cause pain when you ejaculate.

How can I lower my PSA quickly?

There’s no guaranteed way to lower your PSA levels. However, some research suggests that changes to your lifestyle and diet may help reduce your PSA levels. These tips include:

• Eating more foods that contain lycopene. Lycopene is a chemical that gives certain fruits and vegetables their pink or red color. It may have potential anticancer properties. Foods that contain a lot of lycopene include tomatoes, watermelon, apricots, grapefruit and pink guavas.
• Consider a plant-based diet. A diet high in vegetables and legumes may increase your immunity and prevent cancer cell growth.
• Take vitamin D. Vitamin D helps build and maintain strong bones and boosts your immune system. Your body makes vitamin D when you spend time in the sun. Foods that contain vitamin D include fatty fish and vitamin D-fortified foods and drinks, such as milk, plant-based milk, orange juice, cereal and oatmeal. A healthcare provider may also recommend vitamin D supplements.
• Increase physical activity. Moderate to vigorous exercise can help reduce your PSA levels. Activities include walking, jogging, lifting weights and recreational sports.

A note from Cleveland Clinic

A prostate-specific antigen test provides important information about your prostate health. It’s a good idea to get regular PSA tests once you reach your 50s. However, if you have elevated risks, talk to a healthcare provider about getting a PSA test earlier. Ensure you follow the provider’s instructions before the test to get the most accurate results. If you have any questions, a provider is available to answer them.