Elevated PSA


Basic Facts

  • Prostate specific antigen (PSA) is a glycoprotein produced by the prostate that increases in a man’s blood when the prostate gland is enlarged, diseased, or inflamed.
  • Elevated PSA levels may indicate a prostate problem.
  • PSA is arguably the best method for monitoring prostate cancer progression and response to treatment.
  • Men should have an annual PSA test beginning at age 50, age 40 if they are in a high-risk group (patients who are black or whose father, grandfather, uncle, or brother has had prostate cancer).

An elevated PSA does not cause symptoms and is not considered a disease. However, it indicates that a prostate condition, or in some cases a procedure, has disrupted the prostate gland, such as:

  • Infections or inflammation;
  • Benign prostatic hyperplasia (BPH) or enlargement;
  • Prostate cancer;
  • A biopsy; or
  • The placement of a device, such as a Foley catheter.


The following conditions or treatments can cause a man’s PSA level to rise:

  • Enlarged prostate;
  • Prostatitis;
  • Biopsy;
  • Medication; and
  • Cancer.


The level of PSA is determined by a blood test called a PSA test. PSA testing measures the number of nanograms (ng) of PSA in a milliliter (mL) of fluid. PSA is considered elevated if it is 4 ng/mL or higher. PSA levels that are 10 ng/mL or higher signal that a man should be aggressively evaluated for cancer.

Clinical research is also showing that the rate that PSA increases may be as important, or even more important in some cases, than the actual PSA value. An annual increase in PSA greater than 20 percent warrants investigation.

PSA is the most sensitive marker for monitoring prostate cancer progression. Given this sensitivity, men should have an annual PSA test done according to the following guidelines:

  • At age 40 years old, for black men or if a man has a father or brother who had prostate cancer; or
  • At age 50 for all other men.

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