Elevated PSA: To Screen or Not to Screen

PSA, an acronym for Prostate Specific Antigen, is a protein produced by the prostate. Detecting a high level of it in a man’s bloodstream could be indicative of prostate cancer. A PSA screen is often common in screenings, but it is an inexact science for a few reasons. First and foremost, there is no abnormal level of PSA in the blood. Previously, levels higher than 4.0 ng/mL were considered suspect and a biopsy would be recommended, but further studies have proved this at least partially incorrect, as many men with higher levels of PSA do not have prostate cancer.

Since PSA is such a variable metric, it's difficult to tell whether an elevated level really means anything is out of the ordinary.

Since PSA is such a variable metric, it’s difficult to tell whether an elevated level really means anything is out of the ordinary.

In fact, many other factors may cause an elevated PSA. Treatable and benign conditions such as prostatitis and benign prostatic hyperplasia (the inflammation and enlargement of the prostate, respectively) could also be the root cause of an “abnormal” level of PSA in the blood.

However, since most studies about PSA focused on primarily white men, it is far more difficult to establish what is normal and what is not for different ethnicities. Individual doctors and oncologists may have their own opinions as to what is a safe level—generally, the higher the PSA, the greater the likelihood of prostate cancer—but there is no set amount.

Many organizations have cautioned against routine PSA screenings for the general populace, since there have been several instances of false-positives leading to unnecessary treatments and complications. Still, it proves beneficial in many cases.

PSA testing is crucial for men with a family history of prostate cancer, and they should begin screenings at around forty. Those who are in remission also need regular testing, as an elevated PSA can be the earliest sign of a relapse, appearing months or even years before other symptoms.

So should you be tested? That decision is up to you and your doctor. If you have any questions, please feel free to contact us or visit our website.