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PSA Test and Its Meaning

Prostate-specific antigen (PSA) is a blood-based biomarker used in prostate cancer screening and follow-up.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is PSA Test and Its Meaning?

Prostate-specific antigen (PSA) is a glycoprotein produced exclusively by the prostate gland. PSA in the blood rises when prostate cells are damaged or when permeability is increased; therefore prostate cancer, BPH, prostatitis and trauma can all cause an increase.

PSA is not the only biomarker for prostate cancer; however, it is the most widely used test for screening and post-treatment follow-up. The generally accepted threshold is 4 ng/mL, but this should be interpreted according to age, race and prostate volume.

Derivative measures such as free PSA ratio, PSA density, PSA velocity and doubling time help to predict cancer risk better than total PSA alone. Newer biomarkers (PCA3, PHI, 4K score) aim to reduce unnecessary biopsies.

Symptoms

PSA is not a symptom but a blood test; it is requested for routine screening even without symptoms
Elevated PSA usually causes no symptoms
Difficulty urinating, frequency and urgency are common to both BPH and prostate cancer
Bone pain (in the back, hip) may indicate advanced-stage prostate cancer

Risk Factors

Older age (PSA rises along with prostate volume)
Family history of prostate cancer
Higher PSA and cancer risk in men of African descent
BPH and prostatitis raise PSA (false positivity)
Rectal examination, biopsy or cystoscopy transiently raise PSA

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Annual PSA testing and rectal examination in all men over 50
  • Beginning screening at 40-45 with a family history of prostate cancer
  • PSA ≥4 ng/mL or markedly higher than the previous value
  • Free/total PSA ratio <15% — for biopsy evaluation
  • Regular PSA follow-up after prostate cancer treatment

Treatment Methods

01
Evaluation of elevated PSA: prostate MRI after excluding active UTI and prostatitis
02
MRI/TRUS fusion or systematic biopsy if MRI shows PI-RADS ≥3
03
Use of additional markers such as PHI, 4K score or PCA3 in low-risk men to avoid unnecessary biopsies
04
PSA monitoring with 5-alpha-reductase inhibitors and prostate volume reduction in BPH-related elevation
05
Regular 3-6-monthly PSA follow-up for remission and recurrence monitoring after prostate cancer treatment
06
Interpretation of PSA results by a urology specialist together with age, prostate volume and clinical findings

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.