Prostate health is crucial for men and an important measure of your prostate health is the level of prostate-specific antigen (PSA) in your blood. PSA protein is produced by prostate cells in the prostate gland. Knowing your PSA level — and understanding PSA levels by age — can help with the early detection of potential prostate issues, including prostate cancer.
Generally, a PSA level under 4.0 nanograms per milliliter (ng/mL) is considered “normal.” But that doesn’t tell the full story because we know that PSA levels can change with age.
When you’re armed with the facts, you can make the best decisions to protect your prostate health.That’s why we’re delving into what PSA levels tell us about prostate health and how the amount of PSA can change depending on your age group. We’ll also explain why it’s important to monitor PSA levels, when there might be cause for concern, and how PSA screenings can help with the early detection of prostate problems.
Prostate-specific antigenplays a role in helping sperm survive after ejaculation. Because PSA naturally “leaks” from the prostate gland into the blood, doctors can check PSA levels through blood tests to look for signs of prostate problems.
PSA tests are commonly used as a screening tool for prostate cancer, which is the most common cancer among men aside from skin cancers. As such, early detection is crucial for better treatment outcomes.
The American Cancer Society recommends that men over 50 at average risk should have a PSA level test every year in addition to a digital rectal exam. Men with higher risk — including African American men or those with a family history of prostate cancer — should start screening at age 45. Those at even higher risk, meaning men with more than one first-degree relative with early prostate cancer, should start prostate cancer screening at 40.
Before you or a loved one starts screening, it’s important to know that an elevated PSA level is not always caused by prostate cancer.
Many factors, including age, can cause PSA levels to rise in the blood. As men get older, the prostate gland can get bigger and “leak” more PSA into the blood. This can increase the PSA value in the blood for older men.
Sometimes a prostate infection can also cause PSA levels to go up. After conducting a PSA test, your doctor may ask you to follow up with a urologist for a prostate biopsy to help provide more information to rule out prostate cancer.
Unlike some screening tests, there’s no specific "normal" or "abnormal" level of PSA that definitively indicates the presence or absence of prostate cancer.
Most lab results will show anything under 4.0 ng/mL as a “normal PSA level.” It's important to know that prostate cancer can still be present even if the PSA level is below this threshold.
To get the most information using a PSA level, doctors use age-specific PSA ranges to interpret PSA levels. Your healthcare provider will consider your age when interpreting PSA results.
Generally, here are the normal PSA levels by age group:
Remember that these normal ranges are not exact and individual variations can occur.
While PSA levels by age change, there are other factors that can produce an elevated PSA level, including benign (non-cancerous) and malignant (cancerous) conditions. It's important to note that a high PSA level doesn’t necessarily mean the presence of prostate cancer.
Below are some common reasons for an elevated PSA, besides increasing age.
Benign Prostatic Hyperplasia (BPH): BPH is a non-cancerous condition where the prostate gland enlarges, causing urinary symptoms such as increased frequency, urgency, weak urine flow, or difficulty urinating. BPH can elevate PSA levels due to increased prostate tissue and cellular activity.
Prostatitis: This condition refers to inflammation or infection of the prostate gland. It can cause symptoms like pain or discomfort in the pelvic area, urinary symptoms, and sometimes fever. Prostatitis can lead to temporary elevation of PSA levels.
Prostate Biopsy or Recent Procedures: Any recent manipulation of the prostate gland, such as a prostate biopsy, cystoscopy, or transurethral resection of the prostate (TURP), can cause a temporary increase in PSA levels.
Urinary Tract Infection (UTI): A urinary tract infection, particularly involving the prostate, can cause inflammation and temporarily raise PSA levels.
Ejaculation: Recent sexual activity or ejaculation can cause a temporary increase in PSA levels. It’s recommended to avoid ejaculation for at least 48 hours before a PSA test to ensure accurate results.
For all men, regardless of age, it's crucial to establish a baseline PSA level through regular screenings to monitor any changes over time. Changes in PSA over time, also known as PSA velocity, can help your doctor with early detection.
A rapid rise in PSA levels over a period of time might signal the need for further testing to look for prostate cancer. Another measure, PSA density, which considers the PSA level relative to the size of the prostate, can also help assess the risk of prostate cancer.
To improve the accuracy of PSA testing, a newer test called free PSA has been developed, which measures the ratio of free PSA (PSA in blood not attached to other proteins in the blood) to total PSA in the blood. This test can also help identify men with a higher likelihood of elevated PSA due to prostate cancer compared to a benign enlarged prostate — because men with benign enlargement have higher levels of free PSA.
Depending on the reason for a high PSA level, you might find that your PSA will decrease over time. If you have a prostate or urinary tract infection that gets treated, your PSA level will likely decrease during follow-up testing. Likewise, you may have lower PSA test results the further out you are from testing after ejaculation or a recent procedure on your prostate.
There’s also some evidence that healthy lifestyle behaviors like a plant-based diet, increased exercise, and stress management techniques might lower PSA levels and even reverse early-stage prostate cancer progression.
If you have an elevated PSA level, reach out to a healthcare professional who can assess your situation. They’ll consider other factors such as family history and symptoms, and perform additional tests (if necessary) to determine the cause of the elevated PSA level.
For men with a PSA level less than 4 ng/mL, there’s still a 15% risk of prostate cancer, between 4-10 ng/mL there’s about a 25% risk, and for those with a PSA level above 10 ng/mL, the risk for prostate increases to over 50%.
If you have an abnormal PSA level and are considered to be at high risk for prostate cancer, there are several steps you can take to appropriately follow up and manage the situation.
You may want to schedule an appointment with a urologist or healthcare professional who specializes in prostate health. They’ll review your medical history, assess your risk factors, and provide guidance on the next steps.
Depending on your specific situation, your healthcare provider may recommend additional tests or procedures to gather more information. These may include:
Prostate cancer screening and early detection are key to optimal prostate health. While knowing average PSA levels by age is helpful, it’s even more important to understand your individual risk factors for prostate cancer. Factors like family history, ethnicity, and any other relevant medical conditions can help guide decision-making about further tests and management.
Ezra offers advanced prostate MRI scans, which provide detailed imaging of the prostate gland. A prostate MRI can detect potential abnormalities in the prostate, including suspicious areas that may indicate the presence of prostate cancer. This imaging modality can be highly sensitive and can detect cancers that may be missed by other screening methods.
Ezra also uses artificial intelligence (AI) algorithms to assist in the analysis of prostate MRI scans. AI can help identify and flag areas of concern for further evaluation, enabling radiologists and healthcare professionals to focus their attention on potentially cancerous regions.
By offering high-quality prostate MRI scans, Ezra aims to detect prostate cancer at an early stage when treatment options are more effective and the chances of successful outcomes are higher. Early detection can potentially lead to less invasive treatment options and a better long-term prognosis.
In addition to prostate cancer screening, Ezra offers ongoing monitoring and follow-up and personalized risk assessments. This comprehensive approach ensures that you or your loved one receives appropriate care and guidance based on your specific needs and risk factors.
If you’re considering prostate cancer screening or want to talk to our team for more information about an Ezra Prostate MRI scan, contact us at (888) 402-3972 or hello@ezra.com. You can also book an Ezra scan.
