What Are the Causes of a High PSA Test Reading?

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A prostate specific antigen, or PSA, test can provide early warning of prostate cancer or other problems. PSA is a protein produced by the prostate gland, and small amounts naturally enter the bloodstream. If a prostate enlarges dues to cancer, normal aging or other health problems, higher levels of PSA enter the blood. The PSA test detects and measures the volume of PSA in the bloodstream. If you're told you have a high PSA level, it's important to understand that there can be several other causes for a high reading (generally 4.0 ng/mL or above) besides cancer.

Frequent Causes

  • According to Langone Medical Center of New York University, several factors can cause a high PSA reading. A common, non-cancerous condition known as benign prostatic hyperplasia leads to enlargement of the prostate. This can increase PSA levels, as can prostatitis, or inflammation of the prostate gland. In general, men have higher levels of PSA in the blood as they age.

Cancer

  • In some cases, a high PSA level does indicate prostate cancer. To make a full diagnosis, a physician will usually recommend a biopsy of the prostate gland. This non-invasive procedure usually takes place in the doctor's office, with the doctor obtaining a sample of prostate tissue through a needle. Fewer than one-third of patients with a high PSA reading receive a diagnosis of prostate cancer.

False Positives

  • According to the Department of Family Medicine at the Virginia Commonwealth University Medical Center, about 70 percent of all high PSA test results are false positives. Recent events such as ejaculation, an infection or pressure placed on the prostate can cause a higher-than-normal PSA reading. Due to the high rate of false positives, doctors often recommend a second PSA test after a positive result.

Aging

  • Prostate levels naturally rise as a man ages. Some cancer treatment centers, including the Mayo Clinic, suggest that PSA readings of 2 to 3 ng/mL might be high for men in the 40s. Levels of 4 or more, considered high in younger men, might be normal for men in their 70s and 80s. The National Cancer Institute says the evidence does not support age-adjusted PSA readings, and does not recommend that doctors adjust their treatment recommendations based on age adjustments.

Controversy

  • According to the National Cancer Institute, a high PSA level provides little to no indication that a person will die of cancer. Prostate cancer usually develops slowly, and older adults will often experience no health problems from the cancer. The institute states that PSA testing has never been proven to reduce the risk of dying from prostate cancer. You may want to discuss the risks and benefits of PSA testing with your doctor before undergoing the test.

References

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