Prostate specific antigen
(PSA) is a protein made by the prostate. Prostate is a walnut-sized gland in men that makes a fluid for semen.
Most PSA is released into semen. Some of it is released into the blood. If there is a problem with the prostate, the PSA level in the blood can become elevated.
Anatomy of the Prostate
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The PSA test is used to: Monitor treatment effectiveness for prostate cancerHelp determine if cancer has returned in men who have already been treated for prostate cancer
Test for other conditions, like
benign prostatic hyperplasia
The PSA test may also be used as a screening tool for
. However, this use is controversial. Talk to your doctor about the risks and benefits of the PSA test, and your personal risk factors for prostate cancer.
There are no major complications associated with this test.
Ejaculation can cause PSA levels to rise. Avoid sexual activity for 24 hours before testing.
Some procedures can elevate PSA levels. Schedule your PSA test several weeks after any of these:
Any prostate surgery, such as
transurethral resection of the prostate
biopsyRectal examProstate massageCystoscopyWait several weeks after successful treatment of prostate infections.
Some medications can lower PSA levels. Talk to your doctor about any medications, herbs, or supplements you take.
You will be asked to sit. An area inside your elbow will be cleaned with an antiseptic wipe. A large band will be tied around your arm. The needle will then be inserted into a vein. A tube will collect the blood from the needle. The band on your arm will be removed. Once all the blood is collected, the needle will be removed. Some gauze will be placed over the site to help stop bleeding. You may also be given a bandage to place over the site.
After the blood sample is collected, you may need to stay seated for 10-15 minutes. If you are lightheaded, you may need to stay seated longer. Once you feel better, you can leave.
The process takes about 5-10 minutes.
It may be uncomfortable when the needle pierces your skin.
The results are usually available in a few days to a week. Your doctor will talk to you about your results.
If your PSA level is slightly elevated, but there are no other reasons to suspect prostate cancer, your doctor may recommend closely following your PSA levels.
If your PSA level is too high, has risen significantly, or the doctor notices a lump during a digital rectal exam, you will probably need to schedule other tests, such as a prostate biopsy.
After the test, call your doctor if any of the following occurs: Bleeding from the puncture siteRed, swollen, or painful puncture siteIf you have not heard from your doctor in 1-2 weeks
Fang J, Metter EJ, et al. PSA velocity for assessing prostate cancer risk in men with PSA levels between 2.0 and 4.0 ng/mL.
How did the USPSTF arrive at this recommendation? US Preventative Services Task Force website. Available at:
http://www.uspreventiveservicestaskforce.org/Page/SupportingDoc/prostate-cancer-screening/how-did-the-uspstf-arrive-at-this-recommendation-. Accessed April 17, 2013.
PSA testing for the pretreatment staging and posttreatment management of prostate cancer: 2013 revision of 2009 best practice statement. American Urological Association website. Available at:
http://www.auanet.org/education/guidelines/prostate-specific-antigen.cfm. Accessed April 17, 2013.
Prostate cancer screening. EBSCO DynaMed website.
http://www.ebscohost.com/dynamed. Updated March 15, 2013. Accessed April 17, 2013.
Prostate-specific antigen (PSA) Test. National Cancer Institute website. Available at:
http://www.cancer.gov/cancertopics/factsheet/Detection/PSA. Updated July 24, 2012. Accessed April 17, 2013.
Screening for prostate cancer: current recommendation. US Preventative Services Task Force website. Available at:
http://www.uspreventiveservicestaskforce.org/prostatecancerscreening/prostatecancerfaq.htm. Accessed April 17, 2013.
Stephan C, Stroebel G, et al. The ratio of prostate-specific antigen (PSA) to prostate volume (PSA density) as a parameter to improve the detection of prostate carcinoma in PSA values in the range of < 4 ng/mL.
5/6/2009 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Schröder FH, Hugosson J, et al. Screening and prostate-cancer mortality in a randomized European study.
N Engl J Med.
Last reviewed January 2015 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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