PSA Test for Prostate Cancer Your PSA levels refer to the amount of Prostate-Specific Antigen in your blood. Getting tested is currently the best tool we have for catching prostate cancer early, when it's most treatable. Jump To Jump To Your Age Your Score Understanding the Numbers Should I get Tested? Find a Free Screening Location What is the PSA Test?The prostate (a gland that is part of the male reproductive system) naturally creates a hormone called the prostate-specific antigen. PSA levels can be measured with a simple blood draw, making it an easy way to identify when a prostate is behaving abnormally. The PSA blood test is frequently the first step in a prostate cancer diagnosis, but your score cannot by itself tell you if the disease is or isn't present.The test is also useful for tracking how effective a prostate cancer patient's treatment is working. Surgery, radiation, hormone therapy, chemo, and other therapies that address cancer will also cause the PSA score to drop significantly. Regular testing is one of the ways your doctor will measure whether or not the cancer has returned.What is Prostate-Specific Antigen?PSA is a protein produced by prostate cells that keeps semen in liquid form so that sperm can swim. Most people who have a prostate will also have PSA in their bloodstream, and a healthy score will be different from person to person. Levels are also expected to change over time, increasing with age, alongside of other medical conditions, and possibly fluctuating after certain physical activities or lifestyle changes.It's entirely possible to have a high PSA score and still be entirely healthy. But PSA levels almost always increase in a patient who has active prostate cancer. This makes the PSA test one of the most valuable tools for catching the disease early, when it is most treatable and most survivable. Downloadable Information What You Need to Know About the PSA Test Download our prostate cancer screening guide for a quick summary of how PSA score is measured, who should be tested (and when), and what happens if your levels are abnormal. View the Guide What Are Normal PSA Levels?There isn't a specific "normal" PSA score. Elevated PSA score is one of the earliest symptoms of prostate cancer, but your PSA score is influenced by several factors, including age, race, nationality, recent activities, medications, and other health conditions that affect prostate health. It's possible to have a high PSA and still be cancer-free, and it's also possible to have cancer but still have a lower-than-average PSA score.Your PSA Score Range Will Usually Increase With AgeAn enlarged prostate is expected as you age. A healthy 60-year-old who has no evidence of prostate cancer will have a PSA score that increases by 3.2% each year (0.04 ng/mL)[1]. This PSA levels chart summarizes a 1996 study's findings[2] for average PSA scores in the United States:Age RangeAverage PSA25-75% of MenHigh (95th Percentile)[3]40-49 Years Old0.72 ng/mL0.4 - 1.1 ng/mL2.5 ng/mL50-59 Years Old1.1 ng/mL0.6 - 2.3 ng/mL3.5 ng/mL60-69 Years Old1.5 ng/mL0.8 - 3.5 ng/mL4.5 ng/mL70-79 Years Old2.0 ng/mL0.9 - 4.9 ng/mL6.5 ng/mLDifferent Studies, Different FindingsStudies have significantly different results based on patient nationality, race, and environmental factors[4]. The chart above came from a 1996 study of Walter Reed Army Medical Hospital patients. It combines two different sets of data, as the findings show that Black patients had significantly higher average PSA scores than their white counterparts. It's also known that veterans have an increased chance of prostate cancer, further influencing these numbers.In other words, finding a target PSA score that works for everyone, everywhere, is a challenge. In the past, doctors looked at the top 95% of scores to establish a cut-off (depending on your age, anything above 3.0-4.5 ng/mL was considered suspicious). More recently, knowing that no specific "good" or "bad" PSA number exists, recommendations for early detection have become more nuanced, looking at things like your age, risk factors, and previous test results.Catching prostate cancer before it has a chance to spread can save your life. What matters most is knowing your risk and getting tested when recommended based on expert guidelines, rather than comparing your PSA score to the normal range across other patients. What is a "Dangerous" PSA Level for my Age?The National Comprehensive Cancer Network (NCCN) is a not-for-profit alliance of leading cancer centers, and they regularly publish expert guidelines for early detection of prostate cancer. This graphic summarizes their Clinical Practice Guidelines In Oncology for Prostate Cancer Early Detection (NCCN Guidelines®). Please use these guidelines to have a discussion with your doctor about your personal risk and make a plan for screening.This chart helps explain PSA levels by age, and how scores should be interpreted differently based on your race, family history, past test results, and other factors.If you are between ages 40 and 75, andAre Black/African American, and/orHave a family history of cancer and/or a known genetic mutation that increases the risk for prostate cancerDiscuss the risk and benefits of prostate cancer screening with your doctorHave a baseline PSA and strongly consider a baseline digital rectal exam (DRE)If PSA less than 1 ng/mL and DRE normal (if done), repeat testing every 2 - 4 yearsIf PSA 1 - 3 ng/mL and DRE normal (if done), repeat testing every 1 - 2 yearsIf you are between ages 45-75, and are at average risk:Discuss the risk and benefits of prostate cancer screening with your doctorHave a baseline PSA and strongly consider a baseline DREIf PSA less than 1 ng/mL and DRE normal (if done), repeat testing every 2 - 4 yearsIf PSA 1 - 3 ng/mL and DRE normal (if done), repeat testing every 1 - 2 yearsIf you are over age 75Talk with your doctor about if prostate cancer screening should continueIf PSA less than 4 ng/mL and DRE normal (if done), repeat testing in select patients every 1 - 4 yearsIf PSA greater than 4 ng/mL or a very suspicious DRE, talk with your doctor about further testing and follow-upClick here to download the PSA levels recommendations chart in image, PDF, or print format. What Does My Specific Test Result Mean?To summarize the charts above, many doctors start to look at your PSA score as abnormal based on the following age-specific ranges:Younger than 49 and have a PSA score higher than 2.0 - 2.5 ng/mL.Ages 50-75 and have a PSA over 3.0 - 3.5 ng/mL.Older than 75 with a PSA above 4.0 ng/mL.What if my PSA level is high?You and your doctor can explore several options if your PSA is high. One option is to have a second PSA screening; recent research has shown that a second screening can improve the accuracy of an abnormal result. A digital rectal exam (DRE) can also provide more information, and a biopsy can confirm the presence or absence of prostate cancer. However, there are several other reasons why a PSA result might be high, including advanced age, ejaculation within the past 24 hours, and recently riding a bicycle.If you have an elevated PSA, talk with your doctor about your activities and your health. Additional tests may also be recommended.What if my PSA level is low?In general, a low PSA is a good result. However, there are some reasons a PSA level may be artificially low, including taking statins to lower cholesterol, anti-inflammatory drugs, and obesity (body fat decreases the amount of PSA circulating in the bloodstream). Be sure to discuss these with your doctor.What if my PSA is rising quickly?The rate of yearly increase in the PSA level is known as the PSA velocity. An abnormally high PSA velocity can be a sign of prostate cancer, so it's one measure of risk that your doctor will use to consider next steps. This can be especially useful to find prostate cancer in early stages before the cancer has left the prostate.What if I’ve Had Prostate Cancer Treatment, and my PSA Levels are Rising?When PSA levels rise to a certain threshold after prostate cancer treatment, this is known as biochemical recurrence. This means that some cancer cells have survived and are producing the prostate-specific antigen hormone. If this happens, the doctor will order additional tests and make recommendations for additional treatment.What Additional Tests May be Needed?A biopsy (removing tissue from the prostate and looking at it under a microscope) is the definitive way to know if cancer exists. But biopsies can have significant side effects, so doctors may order additional tests before resorting to this surgical procedure. These tests can help predict how likely a biopsy is to find cancer beforehand, or to set expectations for how likely aggressive forms of cancer are to be found.These additional screening tools look at various enzymes, proteins, genetic markers, and other factors found in the bloodstream, urine, or other cells in the body. While none of these tests are currently considered conclusive on their own, when performed together they can provide each patient with more information about their specific cancer and can aid in both the diagnosis and decision on treatment. Read more about additional tests for prostate cancer. What is the Latest Information on PSA Screening Recommendations?The latest NCCN recommendations are covered above in the Prostate Cancer Early Detection: Age Recommendations and PSA Levels Chart.In 2012, the U.S. Preventive Services Task Force (USPSTF) assigned the PSA test a “D” rating. This meant that the USPSTF concluded the harms that resulted from prostate cancer over-treatment (such as unnecessary biopsies and negative side effects of therapies), outweighed the benefits of finding and managing the disease early. This recommendation did not include exceptions for men at increased risk of developing the disease, such as Black or African American men, those with a family history of the disease, and those with BRCA gene mutations. The USPSTF recommendation is important as it guides primary care physicians in preventive care and can impact insurance coverage and reimbursement for screening. Prior to its “D” rating, the screening had an “I” rating, meaning the USPSTF concluded there was insufficient evidence to assess the pros and cons of testing.In 2018, the USPSTF updated their recommendation on PSA screening, assigning the blood test a “C” rating for men ages 55 to 69 (the test still has a “D” rating for men ages 70+). This was in response to research demonstrating the benefits of PSA screening (such as the European Randomized Study of Screening for Prostate Cancer), an increase in the number of men choosing active surveillance, and advocacy efforts.This means that the USPSTF recognizes a small potential benefit of prostate cancer screening and recommends that men make individual decisions about whether or not to get tested after discussing the risks and benefits with their doctors. Like the 2012 recommendation, this update does not include specific language for men at increased risk.The National Comprehensive Cancer Network® (NCCN) and ZERO strongly recommend that men should be fully educated about prostate cancer, should know their options for early detection, and should have access to the tests we have available now. Researchers, with support from organizations like ZERO, are working every day to improve prostate cancer screening, but for now, we must use the tools we have. Your PSA score is an important part of making a decision on how best to determine a prostate cancer diagnosis and/or treatment pathway. Learn more about ZERO's advocacy efforts in early detection and access to PSA screening.How Can I Get a PSA Test?Talk to your primary care doctor or urologist about receiving a PSA test in their office. If you do not have a doctor or insurance (or if your insurance does not cover PSA screening), take a look at ZERO's free PSA screening search tool and see if there are sites near you where free testing may be available. ReferencesOesterling JE, Jacobsen SJ, Chute CG, Guess HA, Girman CJ, Panser LA, Lieber MM. Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges. JAMA. 1993 Aug 18;270(7):860-4.Studies have found differences based on where men lived, including ones from the Mayo Clinic (MN), Walter Reed Army Medical Center (MD), Southeastern U.S., Japan, Taiwan, Iran, and China.David MK, Leslie SW. Prostate Specific Antigen. StatPerls[Internet]. 2022 Nov 10; referenced online at https://www.ncbi.nlm.nih.gov/books/NBK557495.Morgan TO, Jacobsen SJ, McCarthy WF, Jacobson DJ, McLeod DG, Moul JW. Age-specific reference ranges for serum prostate-specific antigen in black men. NEJM. 1996 Aug 1;335(5):304-10. Free Prostate Cancer Testing Near You Talk to your doctor about your risk for prostate cancer and when to begin PSA testing. If you do not have a doctor, do not have insurance, or cannot afford a test, find out if free screenings are available in your area. Find a Free Screening Location
Jump To Jump To Your Age Your Score Understanding the Numbers Should I get Tested? Find a Free Screening Location
What is the PSA Test?The prostate (a gland that is part of the male reproductive system) naturally creates a hormone called the prostate-specific antigen. PSA levels can be measured with a simple blood draw, making it an easy way to identify when a prostate is behaving abnormally. The PSA blood test is frequently the first step in a prostate cancer diagnosis, but your score cannot by itself tell you if the disease is or isn't present.The test is also useful for tracking how effective a prostate cancer patient's treatment is working. Surgery, radiation, hormone therapy, chemo, and other therapies that address cancer will also cause the PSA score to drop significantly. Regular testing is one of the ways your doctor will measure whether or not the cancer has returned.What is Prostate-Specific Antigen?PSA is a protein produced by prostate cells that keeps semen in liquid form so that sperm can swim. Most people who have a prostate will also have PSA in their bloodstream, and a healthy score will be different from person to person. Levels are also expected to change over time, increasing with age, alongside of other medical conditions, and possibly fluctuating after certain physical activities or lifestyle changes.It's entirely possible to have a high PSA score and still be entirely healthy. But PSA levels almost always increase in a patient who has active prostate cancer. This makes the PSA test one of the most valuable tools for catching the disease early, when it is most treatable and most survivable.
Downloadable Information What You Need to Know About the PSA Test Download our prostate cancer screening guide for a quick summary of how PSA score is measured, who should be tested (and when), and what happens if your levels are abnormal. View the Guide
What Are Normal PSA Levels?There isn't a specific "normal" PSA score. Elevated PSA score is one of the earliest symptoms of prostate cancer, but your PSA score is influenced by several factors, including age, race, nationality, recent activities, medications, and other health conditions that affect prostate health. It's possible to have a high PSA and still be cancer-free, and it's also possible to have cancer but still have a lower-than-average PSA score.Your PSA Score Range Will Usually Increase With AgeAn enlarged prostate is expected as you age. A healthy 60-year-old who has no evidence of prostate cancer will have a PSA score that increases by 3.2% each year (0.04 ng/mL)[1]. This PSA levels chart summarizes a 1996 study's findings[2] for average PSA scores in the United States:Age RangeAverage PSA25-75% of MenHigh (95th Percentile)[3]40-49 Years Old0.72 ng/mL0.4 - 1.1 ng/mL2.5 ng/mL50-59 Years Old1.1 ng/mL0.6 - 2.3 ng/mL3.5 ng/mL60-69 Years Old1.5 ng/mL0.8 - 3.5 ng/mL4.5 ng/mL70-79 Years Old2.0 ng/mL0.9 - 4.9 ng/mL6.5 ng/mLDifferent Studies, Different FindingsStudies have significantly different results based on patient nationality, race, and environmental factors[4]. The chart above came from a 1996 study of Walter Reed Army Medical Hospital patients. It combines two different sets of data, as the findings show that Black patients had significantly higher average PSA scores than their white counterparts. It's also known that veterans have an increased chance of prostate cancer, further influencing these numbers.In other words, finding a target PSA score that works for everyone, everywhere, is a challenge. In the past, doctors looked at the top 95% of scores to establish a cut-off (depending on your age, anything above 3.0-4.5 ng/mL was considered suspicious). More recently, knowing that no specific "good" or "bad" PSA number exists, recommendations for early detection have become more nuanced, looking at things like your age, risk factors, and previous test results.Catching prostate cancer before it has a chance to spread can save your life. What matters most is knowing your risk and getting tested when recommended based on expert guidelines, rather than comparing your PSA score to the normal range across other patients.
Age RangeAverage PSA25-75% of MenHigh (95th Percentile)[3]40-49 Years Old0.72 ng/mL0.4 - 1.1 ng/mL2.5 ng/mL50-59 Years Old1.1 ng/mL0.6 - 2.3 ng/mL3.5 ng/mL60-69 Years Old1.5 ng/mL0.8 - 3.5 ng/mL4.5 ng/mL70-79 Years Old2.0 ng/mL0.9 - 4.9 ng/mL6.5 ng/mL
What is a "Dangerous" PSA Level for my Age?The National Comprehensive Cancer Network (NCCN) is a not-for-profit alliance of leading cancer centers, and they regularly publish expert guidelines for early detection of prostate cancer. This graphic summarizes their Clinical Practice Guidelines In Oncology for Prostate Cancer Early Detection (NCCN Guidelines®). Please use these guidelines to have a discussion with your doctor about your personal risk and make a plan for screening.This chart helps explain PSA levels by age, and how scores should be interpreted differently based on your race, family history, past test results, and other factors.If you are between ages 40 and 75, andAre Black/African American, and/orHave a family history of cancer and/or a known genetic mutation that increases the risk for prostate cancerDiscuss the risk and benefits of prostate cancer screening with your doctorHave a baseline PSA and strongly consider a baseline digital rectal exam (DRE)If PSA less than 1 ng/mL and DRE normal (if done), repeat testing every 2 - 4 yearsIf PSA 1 - 3 ng/mL and DRE normal (if done), repeat testing every 1 - 2 yearsIf you are between ages 45-75, and are at average risk:Discuss the risk and benefits of prostate cancer screening with your doctorHave a baseline PSA and strongly consider a baseline DREIf PSA less than 1 ng/mL and DRE normal (if done), repeat testing every 2 - 4 yearsIf PSA 1 - 3 ng/mL and DRE normal (if done), repeat testing every 1 - 2 yearsIf you are over age 75Talk with your doctor about if prostate cancer screening should continueIf PSA less than 4 ng/mL and DRE normal (if done), repeat testing in select patients every 1 - 4 yearsIf PSA greater than 4 ng/mL or a very suspicious DRE, talk with your doctor about further testing and follow-upClick here to download the PSA levels recommendations chart in image, PDF, or print format.
What Does My Specific Test Result Mean?To summarize the charts above, many doctors start to look at your PSA score as abnormal based on the following age-specific ranges:Younger than 49 and have a PSA score higher than 2.0 - 2.5 ng/mL.Ages 50-75 and have a PSA over 3.0 - 3.5 ng/mL.Older than 75 with a PSA above 4.0 ng/mL.What if my PSA level is high?You and your doctor can explore several options if your PSA is high. One option is to have a second PSA screening; recent research has shown that a second screening can improve the accuracy of an abnormal result. A digital rectal exam (DRE) can also provide more information, and a biopsy can confirm the presence or absence of prostate cancer. However, there are several other reasons why a PSA result might be high, including advanced age, ejaculation within the past 24 hours, and recently riding a bicycle.If you have an elevated PSA, talk with your doctor about your activities and your health. Additional tests may also be recommended.What if my PSA level is low?In general, a low PSA is a good result. However, there are some reasons a PSA level may be artificially low, including taking statins to lower cholesterol, anti-inflammatory drugs, and obesity (body fat decreases the amount of PSA circulating in the bloodstream). Be sure to discuss these with your doctor.What if my PSA is rising quickly?The rate of yearly increase in the PSA level is known as the PSA velocity. An abnormally high PSA velocity can be a sign of prostate cancer, so it's one measure of risk that your doctor will use to consider next steps. This can be especially useful to find prostate cancer in early stages before the cancer has left the prostate.What if I’ve Had Prostate Cancer Treatment, and my PSA Levels are Rising?When PSA levels rise to a certain threshold after prostate cancer treatment, this is known as biochemical recurrence. This means that some cancer cells have survived and are producing the prostate-specific antigen hormone. If this happens, the doctor will order additional tests and make recommendations for additional treatment.What Additional Tests May be Needed?A biopsy (removing tissue from the prostate and looking at it under a microscope) is the definitive way to know if cancer exists. But biopsies can have significant side effects, so doctors may order additional tests before resorting to this surgical procedure. These tests can help predict how likely a biopsy is to find cancer beforehand, or to set expectations for how likely aggressive forms of cancer are to be found.These additional screening tools look at various enzymes, proteins, genetic markers, and other factors found in the bloodstream, urine, or other cells in the body. While none of these tests are currently considered conclusive on their own, when performed together they can provide each patient with more information about their specific cancer and can aid in both the diagnosis and decision on treatment. Read more about additional tests for prostate cancer.
What is the Latest Information on PSA Screening Recommendations?The latest NCCN recommendations are covered above in the Prostate Cancer Early Detection: Age Recommendations and PSA Levels Chart.In 2012, the U.S. Preventive Services Task Force (USPSTF) assigned the PSA test a “D” rating. This meant that the USPSTF concluded the harms that resulted from prostate cancer over-treatment (such as unnecessary biopsies and negative side effects of therapies), outweighed the benefits of finding and managing the disease early. This recommendation did not include exceptions for men at increased risk of developing the disease, such as Black or African American men, those with a family history of the disease, and those with BRCA gene mutations. The USPSTF recommendation is important as it guides primary care physicians in preventive care and can impact insurance coverage and reimbursement for screening. Prior to its “D” rating, the screening had an “I” rating, meaning the USPSTF concluded there was insufficient evidence to assess the pros and cons of testing.In 2018, the USPSTF updated their recommendation on PSA screening, assigning the blood test a “C” rating for men ages 55 to 69 (the test still has a “D” rating for men ages 70+). This was in response to research demonstrating the benefits of PSA screening (such as the European Randomized Study of Screening for Prostate Cancer), an increase in the number of men choosing active surveillance, and advocacy efforts.This means that the USPSTF recognizes a small potential benefit of prostate cancer screening and recommends that men make individual decisions about whether or not to get tested after discussing the risks and benefits with their doctors. Like the 2012 recommendation, this update does not include specific language for men at increased risk.The National Comprehensive Cancer Network® (NCCN) and ZERO strongly recommend that men should be fully educated about prostate cancer, should know their options for early detection, and should have access to the tests we have available now. Researchers, with support from organizations like ZERO, are working every day to improve prostate cancer screening, but for now, we must use the tools we have. Your PSA score is an important part of making a decision on how best to determine a prostate cancer diagnosis and/or treatment pathway. Learn more about ZERO's advocacy efforts in early detection and access to PSA screening.How Can I Get a PSA Test?Talk to your primary care doctor or urologist about receiving a PSA test in their office. If you do not have a doctor or insurance (or if your insurance does not cover PSA screening), take a look at ZERO's free PSA screening search tool and see if there are sites near you where free testing may be available.
ReferencesOesterling JE, Jacobsen SJ, Chute CG, Guess HA, Girman CJ, Panser LA, Lieber MM. Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges. JAMA. 1993 Aug 18;270(7):860-4.Studies have found differences based on where men lived, including ones from the Mayo Clinic (MN), Walter Reed Army Medical Center (MD), Southeastern U.S., Japan, Taiwan, Iran, and China.David MK, Leslie SW. Prostate Specific Antigen. StatPerls[Internet]. 2022 Nov 10; referenced online at https://www.ncbi.nlm.nih.gov/books/NBK557495.Morgan TO, Jacobsen SJ, McCarthy WF, Jacobson DJ, McLeod DG, Moul JW. Age-specific reference ranges for serum prostate-specific antigen in black men. NEJM. 1996 Aug 1;335(5):304-10.
Free Prostate Cancer Testing Near You Talk to your doctor about your risk for prostate cancer and when to begin PSA testing. If you do not have a doctor, do not have insurance, or cannot afford a test, find out if free screenings are available in your area. Find a Free Screening Location