PSA Screening for Prostate Cancer

One form of cancer screening for men is the PSA test, which measures the amount of prostate-specific antigen (PSA) in a man’s blood.

PSA is a protein produced by both cancerous and noncancerous tissue in the prostate, a small gland that sits below a man's bladder. The PSA test may be used with or without an accompanying digital rectal exam to test for signs of prostate cancer.

A useful but imperfect test

The PSA test is not a perfect test, and many factors can affect its results. This can lead to false positives and false negatives. If you’re a man over 50, or you’re younger with risk factors like family medical history of prostate cancer, talk with your primary care doctor during your annual physical. They will help you decide if a PSA test is right for you.

In general, the higher a man’s PSA level, the more likely he has prostate cancer. A continuous rise in a man’s PSA level over time can also signal prostate cancer.

When helping you decide what steps to take if your PSA level is elevated, your physician will take into consideration risk factors such as:

  • Race: Black men are more prone to prostate cancer than white or Hispanic men.
  • Age: Risk increases with age.
  • Family medical history: Men who have an immediate family member with prostate cancer are at increased risk.

Elevated PSA is just a start

An elevated PSA result doesn’t mean you have cancer.

  • If test results indicate elevated PSA levels but you have no symptoms of prostate cancer, your doctor may repeat the test to confirm the results. You may also be tested at regular intervals over time.
  • If levels continue to rise or if a lump is found, additional tests such as ultrasound, X-rays or cystoscopy (fiber optic imaging via the urethra — the tube that carries urine from the bladder to the end of the penis) may be recommended to help rule out prostate cancer.
  • If you show signs of prostate cancer, your provider may recommend a biopsy. During this procedure, a hollow needle collects several samples of prostate tissue for a pathologist to examine under a microscope. This will let you and your doctor know if you truly have prostate cancer.