An overview of the PSA levels
A substance produced by the prostate gland, prostate-specific antigen (PSA) is measured using a simple blood test. This test may help in detecting early prostate cancer. However, having high levels of PSA does not always mean that the person is suffering from prostate cancer, there are many reasons for the increase of PSA levels in the blood. With a high PSA level, one may need further checks, including a biopsy, which may be painful and may lead to the presence of blood in urine, semen, or stools.

Below is some information about the causes of elevation in PSA levels, its normal levels, and more.

What causes the elevation of PSA in blood?

• It is believed that there is an increase of PSA in the blood because of its release into the circulation caused by a breakdown of the prostate cellular structure. However, the reasons are not still clear.
• There may be an elevation in the PSA level because of different prostate conditions, which may be because of a prostate cancer or a result of some non-cancerous cause.
• It must be noted that PSA is not only related to prostate cancer, but to prostate tissue; hence, an increase in the PSA levels may indicate the presence of any kind of prostate disorder.
• Additionally, it may also be because of vigorous exercising that may affect the prostate, like bicycle riding.

How is age associated with PSA levels?

• The relation between age and PSA levels has been well documented.
• As men age, the serum PSA levels also increase.
• Presently, amongst men of all ages, a single differentiation between normal and increased PSA value of 4.0 ng/mL is used as a signal for biopsy.
• Making use of age-specific reference levels would possibly help with the several shortcomings of the PSA test.
• Moreover, many unnecessary (false-positive) biopsies can be avoided.
• But, the relation between the PSA levels and age is not absolutely clear, and whether or not age-specific reference levels represent the satisfactory interpretive index for PSA stays complicated.

Is there any impact of race on age-specific reference ranges of PSA?

• Several researchers have evaluated the impact of race on age-specific PSA reference ranges.
• It is found that most black men have higher PSA levels as compared to white men regardless of age.

How is the PSA test conducted?

• The PSA test is a test in which the levels of protein in the blood are measured.
• It is released by the prostate in the semen where it liquefies the semen following ejaculation.
• Most of the PSA produced is carried out of the body in the semen so a very small amount of PSA is left in the blood, which is represented in nanograms per milliliter (ng/mL).
• Checking the normal PSA levels age chart may be helpful in understanding the results of the PSA test.
• If the PSA level is high for the age or is gradually increasing, further investigation, that is a prostate biopsy, may be suggested.
• Other risk factors like family history, the volume of prostate, the presence of benign prostatic hyperplasia (BPH), urinary symptoms, rectal test findings, ethnicity, and medicines that one was taking earlier than suggesting the biopsy have also to be considered.

What do you mean by PSA velocity and PSA doubling time?

• A change in the levels of PSA over time is used in the assessment of both cancer risk and aggressiveness of the particular tumor.
• The rate of change in the PSA over a period of time is known as the PSA velocity.
• The time taken by PSA value to increase by 100% (or get doubled) is known as PSA doubling.

What are the limitations of the PSA test?

• The PSA value is a continuous parameter; the higher the value the higher is the probability of having prostate cancer.
• But, on the other hand, despite having low levels of PSA, men may have prostate cancer.
• In one of the studies in the country, 6.6% of the men whose PSA level was less than 0.5 ng/mL had prostate cancer.
• Hence, even though age and ethnicity-based normal reference ranges do exist, they have got some limitations.
• Moreover, PSA does not allow one to predict the probability of having the presence of clinically significant prostate cancer. Consequently, subjecting men to potentially needless biopsy and treatments.