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Normal PSA Levels

Normal PSA Levels

PSA is a kind of protein secreted by the prostate gland in men. Young adults may have slightly low PSA than the elderly; because PSA levels rise naturally as a man ages. Scroll down to know more about normal and elevated PSA levels and who should check PSA regularly.
Leena Palande
Last Updated: Jun 3, 2018
The protein released by the prostate gland in men is referred to as 'prostate specific antigen' or PSA. PSA test has become a boon for the mankind as it has saved the lives of millions of men. PSA test is a simple blood test, with the help of which PSA levels in blood are measured. Prostate cancer mortality rates have significantly dropped down (by about 6%) since 1992, as more and more people are undergoing PSA test. This test helps detect prostate cancer at an earlier stage. Early detection and prompt treatment help cure the cancer. To analyze the test reports, it is necessary to know the normal value of PSA in men.
PSA Levels in Men
PSA less than 4 ng/mL (nanograms per milliliter of blood) is regarded as normal PSA for men. After surgical removal of the prostate gland, the amount of PSA in blood should be 0 ng/mL. Some laboratories consider PSA less than 2.5 ng/mL or 3 ng/mL as the normal PSA levels for men. Since PSA, higher than the cut-off value, indicates increased chances of having prostate cancer, it is argued that less cut-off value can help detect more early-stage prostate cancer cases. But according to some researchers, this may result in over-diagnosis. Experts say that it is wrong and unnecessary to treat those conditions which are never going to cause any health problem in future. So, In general, 4 ng/mL PSA is referred to as the standard cut-off value for men between age 50 and 70.
Interpretation of PSA Numbers
PSA Value Interpretation
Less than 4 ng/mL Normal
4 - 10 ng/mL 20 - 30 % risk of cancer
10 - 20 ng/mL 50 - 75 % risk of cancer
Above 20 ng/mL 90 % risk of cancer

Elevated PSA does not always indicate cancer. Not only cancer but several other prostate problems can affect the PSA levels.
Causes of Elevated PSA in Blood
Enlarged Prostate: Prostate disorders like Benign Prostatic Hyperplasia (BPH) or enlarged prostate can cause a rise in blood PSA. Most elderly people suffer from enlarged prostate.

Infection in Prostate: Infected or inflamed prostate, (condition known as prostatitis) may exhibit high PSA levels.

Certain Tests: There can be an increase in PSA due to recently performed DRE (Digital Rectal Exam) or prostate biopsy.

Certain Medicines: It is necessary to inform your doctor about the routine medicines before undergoing PSA test; because certain medicines can lead to a rise in PSA levels.

Prostate Size: A larger PSA gland may be responsible for higher PSA levels. Therefore, PSA density is also taken into consideration while measuring the levels. PSA velocity also helps determine the cause of the elevated levels.

Other Causes: Not only the prostate health problems but ejaculation, cycling can raise the levels of PSA.
Digital Rectal Exam
Since a number of factors are responsible for elevated PSA levels, doctors usually order a DRE, when a PSA test shows high PSA numbers. DRE helps evaluate prostate health. During DRE, the doctor inserts his gloved finger through the anus and checks the walls of the rectum for the abnormal growth of the prostate gland. Bumps in the rectal wall indicate enlarged prostate. After 3-4 weeks, your doctor might ask you to undergo another PSA test. The diagnosis is confirmed after seeing the results of two consecutive tests. Sometimes, after seeing a slight rise in PSA levels, the doctor may ask you to wait and watch. Then, you may have to undergo PSA tests at regular intervals. Consistently high PSA indicates prostate cancer. The diagnosis is confirmed after biopsy.
PSA Levels by Age
The cut-off value for PSA can be slightly different for the young and the elderly. The age-adjusted normal PSA levels are described below:

PSA Value Normal for Men
Less than 2.4 ng/mL Under the Age of 50 Years
3 ng/mL or Less Under the Age of 60 Years
4 ng/ml or Less In the Age Group of 60 to 69
5 ng/ml or Less Aged Over 70 Years

The blood PSA volume may vary according to the age of the person. For example, 3 ng/mL PSA may be normal for a 60-year old, but if a man belonging to the age group of 40-49 has 3 ng/mL, then it can be a cause of concern since it indicates increased risk for cancer.
After the prostate surgery, patients need to undergo PSA tests regularly, as they help monitor PSA levels. African-Americans and the men with family history of prostate cancer are more susceptible to prostate cancer and therefore they need to undergo PSA tests regularly after the age of 40. All other men may undergo PSA test regularly after the age of 50. Normal PSA levels may vary slightly from person to person and discussing the PSA results with your doctor may help clear all your doubts.
Disclaimer: This article is for informative purposes only, and should not be used as a replacement for expert medical advice.