Prostate Specific Antigen (PSA) Test
Prostate cancer is a serious condition. The prostate specific antigen (PSA) test is a blood test to see if you might have prostate cancer and to monitor treatment for prostate cancer.
The PSA blood level is also increased in other conditions. So having an increased PSA test result does not mean that you have prostate cancer. Experts disagree on how useful the PSA test is. There is a lot of ongoing research about PSA. At the moment there is no national screening programme for prostate cancer in the UK.
This leaflet is part of our series on prostate problems
What is the prostate gland?
The prostate gland (just called prostate from now on) is only found in men. It lies just beneath the bladder. It is normally about the size of a chestnut.
The tube which passes urine from the bladder (this is called the urethra) runs through the middle of the prostate. The prostate's main function is to produce fluid which protects and enriches sperm.
The prostate often gets bigger (enlarges) gradually after the age of about 50. By the age of 70, about 8 in 10 men have an enlarged prostate. It is common for older men to have urinary symptoms caused by a non-cancerous (benign) enlargement of the prostate. Some men also develop prostate cancer. See separate leaflet called Prostate Gland Enlargement for more details.
What is prostate cancer?
Prostate cancer is a cancer which develops from cells in the prostate gland. It is the most common cancer in men in the UK. Each year, about 40,000 men are diagnosed with prostate cancer in the UK. It affects about 1 in 9 men in the UK at some point in their lives. Most cases develop in men over the age of 65.
Prostate cancer is different to most other cancers because small areas of cancer within the prostate are actually very common, especially in older men. These may not grow or cause any problems for many years (if at all). See separate leaflet called Prostate Cancer for more details.
What is a prostate specific antigen (PSA) test?
The PSA test is a blood test that measures the level of PSA in your blood. PSA is made by the prostate gland. The PSA level in your bloodstream is measured in nanograms per millilitre (ng/mL).
When you have a PSA test, you should not have:
- An active urine infection.
- Produced semen during sex or masturbation (ejaculated) in the previous 48 hours.
- Exercised heavily in the previous 48 hours.
- Had a prostate biopsy in the previous six weeks.
- Had an examination of the back passage with a gloved finger (a digital rectal examination) in the previous week.
Each of these may produce an unusually high PSA result.
If you decide to have a PSA test, your doctor will give you a digital rectal examination to feel the prostate. This is to find out if the prostate is enlarged or feels abnormal in any way.
What is a normal result?
The normal range changes as you get older.
PSA Cut-off Values
|40-49||2.0 nanogram/mL or higher|
|50-59||3.0 nanogram/mL or higher|
|60-69||4.0 nanogram/mL or higher|
|70 or older||5.0 nanogram/mL or higher|
|There are no age-specific reference limits for men older than 80 years of age.|
The higher the level of prostate specific antigen (PSA), the more likely it is to be a sign of cancer.
The PSA test can also miss cancer. About 15 in every 100 men who have a normal PSA level do have prostate cancer. A one-off test is not reliable and repeating the test may provide important information.
What causes a raised prostate specific antigen (PSA) level?
A raised PSA level may mean you have prostate cancer but about two out of three men with a raised PSA level will not have prostate cancer.
Other conditions may also cause a raised PSA level, including:
- Inability to pass urine, causing an enlarged bladder (acute retention of urine).
- Enlargement of the prostate that is non-cancerous (benign).
- Older age.
- Urine infection.
- Acute prostatitis.
- Transurethral resection of the prostate (TURP) operation. TURP is an operation used to remove the prostate if you have benign enlargement of the prostate.
- If you have a tube (catheter) to help pass urine
What happens after a prostate specific antigen (PSA) test?
If your PSA level is not raised
You are unlikely to have cancer. No immediate further action is needed but you may need further tests to confirm the result.
If your PSA level is slightly raised
You probably do not have cancer. You might need further tests, including more PSA tests.
If your PSA level is definitely raised
Your GP will refer you to see a doctor who is a specialist for you to have further tests to find out if you have prostate cancer. The specialist will usually arrange for you to have a sample taken (a biopsy) of your prostate gland.
If prostate cancer is found, what are my options?
Further help & information
Tel: 0800 074 8383
Kemp House, 152 City Road, London, EC1V 2NX
Tel: (Helpline) 0800 035 5302, (Admin) 020 7228 5952
Kemp House, 152 City Road, London, EC1V 2NX
Tel: (Helpline) 0800 035 5302, (Admin) 020 3195 3830
Angel Building, 407 St John Street, London, EC1V 4AD
Tel: (Nurse team) 0808 800 4040, (Switchboard) 020 7242 0200
89 Albert Embankment, London, SE1 7UQ
Tel: (Support Line) 0808 808 00 00
Further reading & references
- Prostate cancer risk management programme: overview; Public Health England
- PSA measurements, frequently-asked questions; British Association of Urological Surgeons, March 2016
- Prostate cancer; NICE CKS, January 2011 (UK access only)
- Moyer VA; Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012 Jul 17;157(2):120-34. doi: 10.7326/0003-4819-157-2-201207170-00459.
- Ilic D, Neuberger MM, Djulbegovic M, et al; Screening for prostate cancer. Cochrane Database Syst Rev. 2013 Jan 31;1:CD004720. doi: 10.1002/14651858.CD004720.pub3.
- Wilt TJ, Ahmed HU; Prostate cancer screening and the management of clinically localized disease. BMJ. 2013 Jan 29;346:f325. doi: 10.1136/bmj.f325.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Colin Tidy
Dr Colin Tidy
Dr Adrian Bonsall