Understanding PSA testing
What is a PSA test?
PSA stands for prostate specific antigen, a protein produced by the prostate gland.1 The level of PSA in your blood is measured by a blood test. Levels higher than 3 nanograms per milliliter (ng/mL) indicate there may be an issue with your prostate that should be investigated further.1,2
Why have a PSA test?
The decision to have a PSA test can be tricky. This is because there is no standard level of PSA, plus the level of PSA in your blood can change everyday. In addition, you may have ‘normal’ PSA levels but still have prostate cancer.1,2
If you have symptoms that could be related to an enlarged prostate, it might be a good idea to get a PSA test. Symptoms that could be a warning of a prostate problem include:2
- Trouble peeing
- Blood when you pee or ejaculate
- Pain when peeing
- Needing to go all the time or through the night
- Back or pelvic pain
Who carries out a PSA test?
A PSA test is a simple blood test than can be done through your GP.1
What might the results of a PSA test mean?
It’s important to know that a PSA test is not a test for prostate cancer. An elevated level of PSA in your blood could mean a variety of things, from an enlarged prostate that is benign (not cancerous), inflammation or an infection to a slow-growing cancer or more aggressive prostate cancer.2
You may get what’s called a ‘false positive’ or ‘false negative’ result. A false positive is where your PSA levels appear high, but you don’t have cancer. A false negative is the opposite, where the PSA levels appear within the normal range but you do have prostate cancer. Both are stressful and can lead to more invasive testing being required (such as a biopsy) or to cancer being missed.2.
PSA test is positive - what next?
If your PSA test comes back and your PSA levels are higher than 3 ng/mL your doctor will discuss next steps with you.1,2 This could include additional tests such as a digital rectal exam (the finger up the butt exam), a scan of the area with magnetic resonance imaging (MRI) or a prostate biopsy (where a small piece of prostate tissue is removed and examined for signs of cancer cells).2 Following these tests you and your healthcare team will make a plan of action depending on the result.1
Find out more about prostate cancer here.
- Cancer Council. Understanding prostate cancer. Reviewed March 2022. Available from: https://www.cancercouncil.com.au/prostate-cancer/about-prostate-cancer/ (accessed August 2023).
- Prostate Cancer Foundation of Australia. Should I have a PSA test?. Available from: https://www.pcfa.org.au/awareness/general-information/general-information-resources/ (accessed August 2023).