Prostate Specific Antigen - PSA (Total)

A high PSA can reflect prostate inflammation (prostatitis), benign enlargement (BPH), or prostate cancer, but it’s not diagnostic alone. Clinicians usually repeat the test, assess PSA velocity and free/total ratio, perform a digital rectal exam and may use imaging or a biopsy to determine cause. Recent ejaculation, infection, procedures or age-related changes can raise PSA, so urology follow-up is recommended.

Normal total PSA ranges (ng/mL) by age: under 40: <2.0; 40–49: <2.5; 50–59: <3.5; 60–69: <4.5; 70–79: <6.5. Values above these age-specific cutoffs may prompt further assessment; PSA can be affected by prostate size, infections, ejaculation, and some medications. Individual risk factors like family history or race also influence interpretation; repeat testing or urology referral may be recommended.

A single PSA level does not prove cancer. Traditionally, PSA <4 ng/mL is considered low; 4–10 ng/mL is a “gray zone” (≈25% chance of prostate cancer), while >10 ng/mL substantially raises the likelihood (often >50%) and usually prompts further evaluation (repeat PSA, MRI and biopsy). Age, prostate size, infection and recent procedures can alter PSA—diagnosis requires tissue confirmation.

The PSA "danger zone" is generally considered above about 4 ng/mL. Levels 4–10 ng/mL are a gray zone with increased suspicion and often warrant repeat testing and further assessment; levels above 10 ng/mL carry a substantially higher likelihood of prostate cancer. Age, prostate size, infection, and procedures can raise PSA—elevated results require urology follow-up and diagnostic evaluation.

To lower PSA, treat underlying causes: have infections evaluated and treated and manage benign prostatic hyperplasia with physician‑guided medications (for example, 5‑alpha reductase inhibitors). Adopt healthy weight, regular exercise, and a balanced diet. Avoid ejaculation, vigorous cycling, or prostate stimulation for 48–72 hours before testing. Don’t start or stop medications without medical advice—work with your doctor for appropriate evaluation and treatment.

By age 70 the prostate commonly enlarges with typical volumes ranging about 20–40 mL (roughly grams). Many clinicians regard up to about 30–40 mL as within the expected age-related range; values above this often reflect benign prostatic enlargement (BPH). If urinary symptoms or concerns arise, clinical assessment including digital exam, PSA testing and ultrasound measurement is recommended.