The PSA test result

What is a normal PSA level?

Although the term ‘normal PSA level’ is often used, there isn’t a single number for a normal PSA level. There are a few reasons for this:

• The older you are, the higher your PSA level is likely to be, whether or not you have prostate cancer.
• PSA levels vary with the size of your prostate gland (this differs from man to man and the gland gets bigger with age).
• Different laboratories use different methods to measure PSA levels.
• Specialists have different opinions on what’s ‘normal’.

It’s best to check with your specialist what they think the normal level should be for you. The numbers given here are only a guide and are based on age:

• For men in their 50s, a PSA level of up to 3 nanograms per millilitre of blood (3ng/ml) is considered normal.
• For men in their 60s, a PSA level of up to 4ng/ml is considered normal.
• For men aged 70 and over, a PSA level of up to 5ng/ml is considered normal.

Your PSA test result and what happens next

As a guide, here’s what may happen depending on your PSA test result.

A normal PSA level

You’re unlikely to have cancer. If your prostate feels normal during a digital rectal examination (see below), then no further action is needed.

A high PSA level

There are no rules about what to do if your PSA level is high - even healthcare professionals don’t always agree on the best course of action. If the test shows that the level of PSA in your blood is raised, what happens next depends on:

• whether or not you have any symptoms
• how your prostate gland feels during a digital rectal examination. A digital rectal examination is when a healthcare professional inserts a gloved finger into your rectum (back passage) to feel the prostate. It may be uncomfortable, but it’s quick and shouldn’t be painful.
• your personal risk of prostate cancer.
• whether your PSA is slightly higher than normal or significantly higher than normal (see below).

If your PSA level is slightly higher than normal

In this case you probably don’t have cancer. You might need to have another PSA test in a few weeks. Some men may have a series of PSA blood tests. This is to see whether the level is changing over time and if so, how quickly.

If the PSA level remains abnormal or increases, you may be advised to have a sample of tissue taken from your prostate (a biopsy).

Your doctor or nurse practitioner may also ask you if you were sexually active in the 48 hours before your PSA test, or if you’ve had a recent urine infection. This is because these can raise your PSA level.

If your PSA level is significantly higher than normal

If the levels are a lot higher than normal you probably need to have a prostate biopsy to find out if cancer cells are present.

If the biopsy shows that you have prostate cancer, there are a number of different options for managing it, depending on your particular situation. Your medical team will be able to give you more information about the best options for you.

More information and support

We have a section on further tests for prostate cancer| and more detailed information about prostate cancer| and treatments.

If you’re finding it difficult to cope with the emotions caused by your test results, you can visit our online community|. There, you can get support from people who’ve been through similar experiences to you.