Prostate-specific antigen (PSA) is a protein produced by prostate cells; its blood level helps screen and monitor prostate conditions. Elevated PSA can reflect prostate cancer but also benign prostatic hyperplasia, prostatitis, recent ejaculation, catheterization or urinary retention, and age. PSA alone isn’t diagnostic—clinicians use PSA level, change over time, physical exam, imaging, and sometimes biopsy to determine cause.

If PSA is high, it may indicate prostate cancer but also benign conditions like benign prostatic hyperplasia, prostatitis, recent ejaculation, or medical procedures. Doctors typically repeat the test, check free versus total PSA, and may order imaging (MRI) or a prostate biopsy to confirm diagnosis. Treatment depends on the cause and ranges from antibiotics or watchful waiting to surgery, radiation, or active surveillance for low-risk cancer.

Normal PSA by age: 40–49: <2.5 ng/mL; 50–59: <3.5 ng/mL; 60–69: <4.5 ng/mL; 70–79: <6.5 ng/mL. Values vary by lab, benign prostate enlargement, infection, and medications. A higher PSA doesn’t prove cancer—further evaluation (repeat testing, free/total PSA, imaging, biopsy) is often needed. Interpretation should be individualized.

A PSA above 4 ng/mL is commonly considered abnormal and warrants further evaluation; levels above 10 ng/mL are strongly associated with a higher likelihood of prostate cancer. Rapid increases (PSA velocity >0.75 ng/mL/year) or a low percent free PSA (<10–15%) are also concerning. Age-specific reference ranges and other conditions (infection, enlargement) can raise PSA, so clinical context matters.

To reduce PSA quickly, avoid activities that transiently raise it: no ejaculation, cycling, vigorous exercise, or prostate stimulation for 48–72 hours before testing. Also avoid digital rectal exam and recent urinary catheterization. If infection or prostatitis is suspected, seek medical evaluation—appropriate treatment can lower PSA. Don’t stop or start medications without your doctor; consult your clinician first.

PSA test costs vary widely by country, provider and insurance: in the United States expect roughly $30–$200 for the blood test (higher if billed with a clinic visit), in the UK it is usually free on the public system or about £40–£100 privately, and in India around ₹300–₹1,500. Many insurers or public programs cover screening—check with your doctor or lab for exact pricing.