PSA Test
What Is a PSA Test? What Does an Elevated PSA Mean?
PSA (prostate-specific antigen) is a protein produced by the prostate gland that can also be measured in the blood. A PSA test alone does not diagnose prostate cancer. PSA may be elevated in prostate cancer; however, it can also rise in non-cancerous conditions such as benign prostate enlargement, prostate inflammation or infection. In some prostate cancers, PSA may not be elevated.
Why is a PSA test performed?
PSA measurement may be requested for two different purposes:
- Assessment for early detection: To help assess the risk of prostate cancer in people without symptoms.
- Diagnostic assessment and follow-up: Because of urinary symptoms, examination findings or previous PSA results; also for follow-up after the diagnosis or treatment of prostate disease.
The decision to undergo screening is individualised. The AUA/SUO and the European Association of Urology emphasise providing information about PSA testing and making the decision together with a doctor. The USPSTF recommends that the decision to undergo screening between the ages of 55–69 be made individually by the person and their doctor, and recommends against routine PSA screening at age 70 and above. Because guidelines and individual risks vary, there is no single starting age or testing interval that applies to everyone.
A family history of prostate cancer, particularly in a first-degree relative, certain inherited gene changes or a person's medical history may warrant earlier assessment. The potential benefits of testing and results that could lead to unnecessary further investigations, biopsy or treatment should be discussed with a doctor.
Does an elevated PSA always mean cancer?
No. PSA can also rise due to conditions such as benign prostate enlargement, prostate inflammation or a urinary tract infection. Certain recent procedures involving the prostate or urinary tract may also affect the result. As medicines such as finasteride and dutasteride can lower PSA levels, you should tell your doctor about any medicines you are taking.
There is no single “normal value” threshold for PSA that applies to everyone. The result is assessed alongside age, prostate volume, previous measurements, symptoms and other clinical information. A PSA level found to be elevated for the first time may need to be measured again under appropriate conditions. The EAU recommends repeating PSA before proceeding with further investigations in people without symptoms whose PSA falls within a certain range.
What should you consider before a PSA test?
A blood sample is taken to measure PSA. You should tell your doctor about any symptoms that could affect the result, recent urinary tract infections or procedures involving the prostate/urinary tract, and any medicines you are taking. If your doctor requests a repeat test, they may prefer the same laboratory and similar testing conditions so that the two measurements can be compared.
What investigations may be performed after an elevated PSA result?
The doctor assesses the PSA result alongside the person's medical history, symptoms and examination findings. If necessary, a repeat PSA test, additional blood tests such as the free-to-total PSA ratio, a prostate examination or a prostate MRI may be planned. A urologist decides whether a biopsy is needed following these assessments. An elevated PSA alone does not mean that a biopsy is required or that cancer has been diagnosed.
Frequently asked questions
Does a PSA test definitively detect prostate cancer?
No. PSA is a blood test that helps with assessment; the result alone does not establish a cancer diagnosis or completely rule out cancer.
If my PSA is elevated, do I definitely have prostate cancer?
No. Non-cancerous causes such as prostate enlargement, inflammation or infection can also raise PSA. The result should be assessed by a doctor.
If my PSA is low, is it certain that I do not have prostate cancer?
No. A low PSA may reduce the likelihood of cancer; however, it does not rule out cancer on its own.
At what age or how often should a PSA test be performed?
This decision is made together with a doctor, based on age, family history, individual risks and how the person weighs the benefits and potential harms of testing. There is no fixed testing interval that applies to everyone.
Can I have a PSA test at Wellcare Laboratories?
You can provide a blood sample for a PSA test at our Nicosia and Kyrenia branches. Please consult your doctor for clinical assessment of the result and to determine whether further investigations are needed.