The short answer
The PSA test measures a protein made by the prostate. It can help detect prostate cancer, but it is not recommended for routine screening of everyone because both cancer and benign conditions can raise PSA, and screening carries real harms. NCI describes it as a personal decision to make with your doctor.
PSA is a protein made by normal and cancerous prostate cells; both cancer and benign conditions can raise it.
The PSA test is not recommended for routine screening of the general population.
For men aged 55–69, whether to screen is an individual decision to discuss with a clinician; screening is not recommended at 70 and older.
Benefits (possibly catching cancer earlier) must be weighed against harms like false positives, overdiagnosis, and overtreatment.
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The simple version
Prostate-specific antigen, or PSA, is a protein made by prostate cells. Both normal and cancerous prostate cells make it. The PSA test measures how much PSA is in your blood. Here is the catch. Prostate cancer and benign conditions can both raise PSA. An enlarged prostate (BPH) and inflammation (prostatitis) are common benign causes. That is a big reason the test is not a simple yes-or-no for cancer.
The test is used in three main ways:
- To monitor people already diagnosed with prostate cancer
- To follow up on prostate symptoms
- More controversially, to screen people who have no symptoms
Is PSA screening recommended?
Not routinely. PSA was widely used to screen large numbers of people starting in the late 1980s. As more was learned about its harms, many organizations began to caution against it. Today most recommend that anyone considering PSA screening first discuss the risks and benefits with their doctor.
The U.S. Preventive Services Task Force recommends:
- Ages 55–69: the decision to screen should be an individual one. Weigh the possible benefits and harms against your own values.
- Age 70 and older: PSA-based screening is not recommended.
Some organizations suggest earlier routine testing, at 40 or 45, for people at higher risk. That includes Black men, those with inherited BRCA2 changes (and to a lesser extent BRCA1), and those whose father or brother had prostate cancer.
What counts as a "normal" result
No single cutoff separates normal from abnormal. No level means cancer for sure, though a higher PSA makes cancer more likely. A level above 4.0 ng/mL (nanograms per milliliter of blood) is generally considered abnormal and may lead to a biopsy. Doctors sometimes adjust the cutoff by age or medication. Temporary bumps can come from infection, inflammation, a recent biopsy, or vigorous exercise. If PSA is high, the doctor may repeat the test in 6 to 8 weeks.
Weighing benefits and harms
The possible benefit is catching prostate cancer earlier, when it may be easier to treat. The USPSTF found that screening may prevent a small number of prostate cancer deaths.
The harms are real and important.
- Overdiagnosis and overtreatment. Some cancers found by PSA grow so slowly they would never cause problems. Treating them can still cause urinary, bowel, and sexual side effects.
- False positives are common. Only about 25% of men biopsied for a high PSA turn out to have cancer. Biopsies can also cause pain, bleeding, and infection.
The USPSTF has put numbers on this. For every 1,000 men ages 55–69 screened for 13 years, the USPSTF estimates about 1 prostate cancer death is avoided and about 3 cases of metastatic cancer are prevented. About 100 men are diagnosed. After treatment, about 50 have sexual dysfunction and about 15 have urinary incontinence. This is exactly why NCI frames PSA screening as a personal decision, not an automatic one.
After a prostate cancer diagnosis
The PSA test is also valuable after treatment. Following surgery or radiation, a rising PSA can be the first sign of recurrence (the cancer coming back). It often appears months or years before symptoms. But one high reading does not mean the cancer is back. Doctors look for a rising trend over time, sometimes with imaging, before recommending more treatment.
Sources
Opened and checked on 2026-10-02:
Common questions
What is the PSA test?
Prostate-specific antigen (PSA) is a protein produced by normal as well as cancerous cells of the prostate gland. The PSA test measures the level of PSA in the blood. It's used to monitor prostate cancer in people already diagnosed, to follow up on prostate symptoms, and sometimes to screen for prostate cancer in people without symptoms. Both prostate cancer and benign conditions like BPH and prostatitis can raise PSA.
Is the PSA test recommended for screening?
It is not recommended for routine prostate cancer screening in the general population. Most organizations now recommend that anyone considering PSA screening first discuss the risks and benefits with their doctor. The USPSTF says that for people aged 55 to 69 the decision should be an individual one made after weighing benefits and harms, and that screening is not recommended for those 70 and older.
What is a normal PSA result?
There is no single threshold that separates normal from abnormal, and no specific level that means cancer is present — though the higher the PSA, the more likely cancer is. In general a level above 4.0 ng/mL is considered abnormal and may prompt a biopsy, but doctors sometimes use different cutoffs by age or medication. Infection, inflammation, a recent biopsy, and vigorous exercise can temporarily raise PSA.
What happens if my PSA is elevated?
If someone without symptoms has an abnormal PSA, the doctor may repeat the test in 6 to 8 weeks. If it stays elevated, the next step may be more testing or a prostate biopsy. Ask your doctor what is advised for you.
What are the harms of PSA screening?
Key harms include overdiagnosis and overtreatment — finding slow-growing cancers that would never have caused problems, and treating them, which can cause urinary, bowel, and sexual side effects. The test also produces false positives (elevated PSA with no cancer), which cause anxiety and can lead to biopsies with their own risks of pain, bleeding, and infection. NCI says false positives are common, and only about 25% of men who have a biopsy for an elevated PSA are found to have prostate cancer.
Is the PSA test used after treatment?
Yes. After surgery or radiation for prostate cancer, the PSA test is used to watch for recurrence. A rising PSA can be an early sign the cancer has come back, often months or years before symptoms. But a single elevated reading doesn't always mean recurrence — doctors look for a rising trend over time, sometimes alongside imaging, before recommending further treatment.
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Last updated: 2026-10-02Next planned review: 2027-01-03
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Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes, and this is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. It is not a medical review, and it does not confirm the page is complete or right for your situation.
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