PSA is abbreviated form for prostate specific antigen. It is a protein secreted by the prostate gland. PSA tends to rise naturally with age and hence older men have higher levels of PSA than younger men.
PSA levels can be checked via a PSA blood test. If very high levels of PSA are detected in the test, then doctors may conduct further tests to verify the underlying presence of diseases such as benign prostatic hyperplasia or prostate cancer. Checking for PSA levels is thus useful in early detection and treatment of these severe diseases.
Normal PSA levels in men
- A PSA level of below 4 ng/mL (nanograms per milliliter of blood) is regarded as normal by doctors all over the world. In some labs, PSA test readings of under 2.5 ng/mL or below 3 ng/mL is regarded as normal.
- If the prostate gland has been surgically removed then the normal PSA level in those men is 0 ng/mL
Higher than normal levels of PSA is usually a sign of diseases like prostate cancer. Hence, some doctors prefer a lower PSA level to be the normal PSA level as it can help in early detection and subsequent cure of prostate disorders. Some other experts however believe that having a lower than normal PSA reading as the bar for normal PSA level can lead to over diagnosis and increased medical costs. They are of the opinion that treating conditions (lower than normal PSA level) that may not necessarily cause medical problems in the future is redundant as well as unethical. This is the reason why doctors all over the world 4 ng/mL and below as the normal PSA level in men between the ages 50 to 70 years.
A PSA test report and the normal PSA levels can be easily read and interpreted with the help of the below provided table
|PSA test reading||Interpretation|
|Below 4 ng/mL||Normal|
|From 4 to 10 ng/mL||20 to 30 percent increased risk of cancer|
|From 10 to 20 ng/mL||50 to 75 percent probability of cancer|
|Above 20 ng/mL||90 probability risk of cancer|
A higher than normal PSA level may not necessarily be an indication of prostate cancer. It can also be a sign of other prostate disorders like prostate enlargement, etc.
Normal PSA Levels by age
The normal PSA levels in males that are considered standard by most men tend to differ as per the age, as PSA levels also naturally increase with age. Provided below is a table that classifies the normal levels of PSA as per the age.
|PSA test reading||Normal PSA test value as per age|
|2.4 ng/mL or less||In males younger than 50 years|
|3 ng/mL or less||In males younger than 60 years|
|4 ng/mL or less||In males in the age group of 60 to 69 years|
|5 ng/mL or less||In males older than 70 years|
Causes of above normal PSA levels
Some of the common causes of above normal levels of PSA in men are listed below:
- Size of prostate gland: The size of the prostate gland affects a PSA test reading; if the gland is bigger than normal, then above normal PSA levels will be found. Hence, PSA density is measured when interpreting normal PSA levels. Other measurements like PSA velocity helps find the causes of higher than normal PSA levels.
- Prostate cancer: Any kind of tumor or malignancy in the prostate gland can result in higher than normal PSA levels. A PSA test is the most common tool used for pre-diagnosis of prostate cancer.
- Benign Prostatic Hyperplasia: It is a non-malignant prostate condition marked by enlargement of the gland. It is more prevalent in older men. As the disorder is non-cancerous, it remains isolated to the prostate gland.
- Use of certain drugs: PSA levels in blood can rise above normal due to use of certain medicines. Hence, doctors check the medical history of a patient, including the routine drugs taken daily, to arrive at a correct reading of the PSA levels as well as evaluate the health of the prostate gland.
- Prostatitis: It is an infection of the prostate gland marked by swelling and inflammation as well as higher than normal PSA level test results.
- Diagnostic procedures: If diagnostic tests like a digital rectal exam or a prostate biopsy have been recently carried out, then those men may have PSA test readings that are higher than normal.
- Other causes: Recent cases of ejaculation or cycling can also cause the PSA levels to rise above normal levels.
African American males and those with a family history of prostate cancer are at increased risk to developing prostate cancer. Also, those who have had prostate surgery and those over 50 years of age are vulnerable to varied prostate ailments. It is therefore necessary for such men to regularly take PSA tests for diagnosis and early treatment of varied problems of the prostate gland.
Filed in: Conditions