PSA testing

By regularly testing PSA it's possible to detect early‑stage asymptomatic prostate cancer. The specialists at Docrates recommend that men of 50 to 75 years of age have their PSA level checked each year in a PSA testing.

What is a PSA test and when should it be done?

By regularly testing PSA it’s possible to detect early‑stage asymptomatic prostate cancer. PSA (prostate-specific antigen) is a protein produced by the prostate. Its level in the blood typically increase in prostate cancer and benign prostatic hyperplasia. PSA level can be determined with a simple blood test.

The specialists at Docrates recommend that men of 50 to 75 years of age have their PSA level checked each year in a PSA testing. If close relatives have been diagnosed with cancer, monitoring and testing should begin even earlier. Regular PSA testing helps to assess the cancer risk and the need for any further examinations. Sometimes PCA3 determination can provide additional information.

Even quite low PSA levels can indicate cancer

The significance of the PSA level should always be assessed in proportion to the size of the prostate. The larger the prostate, the higher the PSA level. Even quite low PSA levels can indicate cancer. The level of free PSA is significant in differential diagnostics when assessing benign and malignant lesions. The lower the free PSA level, the higher the risk of cancer. The following table shows the reference values for total PSA in different age groups and the relationship between the percentage of free PSA and cancer risk.

The table below is intended as a rule of thumb for the assessment.

Reference values for PSA

Age (yrs)

S-PSA ( µg/l )

40-49

less than 2,5

50-59

less than 3,5

60-69

less than 4,5

70-79

less than 6,5

Proportion of free PSA (%)

Cancer risk (%)

0-10

56

10-15

28

15-20

20

20-25

18

over 25

8

 

(Sources: Thompson et al.: Prevalence of prostate cancer among men with a prostate-specific antigen level < or = 4.0 ng per milliliter, New England Journal of Medicine, 2004, May 27, and Finnish Current Care guidelines)

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