The protein specific antigen (PSA) blood test is used to help screen men who are at risk of developing prostate cancer. Prostate cancer is the second most common cancer for men after skin cancer and the second leading cause of cancer deaths behind lung cancer, but it is highly treatable when early detection has occurred. The PSA blood test is not recommended for any men under the age of 40 and only men at a high risk of cancer development are recommended to have this screening test before the age of 55. Men above the age of 70 are also not candidates for this blood test.
The average age of prostate cancer diagnosis is 66. About 60% of all prostate cancer cases are diagnosed in men who are above the age of 65.
What Do My Test Results Mean?
PSA blood test results are typically measured in ng/mL numbers, with most men having a PSA level that is below 4. That is the number that most medical providers use as the cutoff point in regards to the risks of prostate cancer development in a patient. Most men who have prostate cancer will have a PSA level above 4, but cancer has also been known to develop in men with normal PSA levels.
Men who have a prostate which feels normal upon examination and have a normal PSA have a 15% risk of developing prostate cancer. If the PSA number is 5-10, then the cancer risks are 25%. Any results that are higher than 10 indicate a cancer risk of up to 67%.
Some medical providers may have a lower cutoff point with their PSA results based on recent research that has been published regarding this blood test. Scores at 2.5-3.0 may be the cutoff for an individual’s medical provider. If any test results are in the 2.5-4.0 range, it is important to speak with a medical provider about the risk potential of that result and how it is reflective of personal health.
It is important to remember that the PSA blood test results are not a perfect screening tool. Enlargement of the prostate through inflammation or prostatitis can also raise PSA levels. The vast majority of prostate cancer cases that are found early, however, are because of the results that are found on the PSA blood test.
What Happens Next?
If PSA levels are in the normal range, especially for men that have a result of 2.5 or less, and the prostate feels normal upon a physical examination, then nothing may be recommended by a medical provider. Men who are overweight may be encouraged to lose some weight if possible, but that may be the extent of the medical advice. A follow-up test in 1-2 years may be recommended depending on the age of the patient.
If PSA levels are concerning, then a medical provider will typically follow-up a positive or high test result with a biopsy. This is ordered to detect the presence of cancer. If the biopsy comes back as normal, then treating the inflammation of the prostate or its enlargement becomes the priority of the treatment plan. If it is positive for cancer, then treating the prostate cancer becomes the priority.
Having a prostate cancer diagnosis can be difficult news to take, but almost 3 million men in the United States alone are survivors of this disease. About 220,000 new cases of prostate cancer are diagnosed in the US every year, but about 27,000 men lose their battle with this cancer annually. It is so common of a cancer than 1 in 7 men will have a positive PSA blood test result at some point in their lives.
Here’s What To Expect
Prostate cancer may be a serious diagnosis, but a positive PSA blood test does not mean that the world is ending. The 5 year survival rate for men who receive this diagnosis is almost 100%. The relative 10 year survival rate of prostate cancers is 99% and the 15 year relative survival rate is 94%. This includes prostate cancers of all stages.
For men who have a result from the PSA blood test that is 10 or under, alternative testing methods may also be employed to add more specificity to the risk factors that are being faced. A measurement of the percent-free PSA may be used because a measurement of less than 10% has a 50/50 chance of a cancer diagnosis. Measurement of PSA velocity and a urine PCA3 test may also be ordered to determine if a biopsy may be necessary.
The PSA blood test results explained here are a reliable method of determining prostate cancer risk factors. Although prostate cancer is serious, it is also very treatable. Speak with a medical provider about personal results and what they may mean so that an accurate diagnosis can be received.