The prostate gland produces a substance called prostate-specific antigen (PSA). Elevated PSA levels may indicate a noncancerous condition, such as prostatitis or an enlarged prostate, prostate cancer, or inflammation. Higher PSA levels may not always point toward cancer, but they need to be checked to help detect any other health conditions. A quick glance at normal PSA levels and age charts online can help understand the normal range of PSA.

How is the PSA measured?

• PSA is measured by a simple blood test; however, it does not require fasting or any specific preparations.
• As the quantity of PSA in the blood is very low, detecting it requires a very sensitive kind of technology like monoclonal antibody technique.
• The PSA protein may exist in the blood itself as free PSA or it may be bounded with other substances known as bound or complex PSA.
• The three substances to which the PSA is usually bounded to are alpha-2-macroglobulin, alpha 1-antichymotrypsin (ACT), and albumin.
• The overall PSA is the sum of both the free and the bound forms. The total PSA that is the sum of both is measured using the PSA test.

What are the normal results for a PSA test?

• The “normal” level of PSA serum remains a subject for debate, but conferring to most laboratory readings, it must be less than 4.0 ng/mL for men.
• There is an increase in the size of the prostate gland and it starts producing more PSA with an increase in age, so it is normal to have increased levels in older men and lower levels in younger men.
• Due to these normal changes in PSA with the age, the idea of age-adjusted PSA normal range has been described and suggested.
• What should be the normal PSA level also relies upon the ethnicity and family history of prostate cancer.
• As soon as an initial PSA has been considered, the change in the PSA over time and the PSA velocity play a very important role in medical decision making.
• For instance, a man between 50 to 59 years of age having a PSA value of 0.5 ng/mL one year and it then increases to 2.5 ng/mL the following year may be considered as having the normal PSA level but the change in the levels of PSA may become worrisome for an underlying prostate cancer.
• An increase in the size of the prostate gland may also affect the PSA level, which may also be a helpful number.
• A PSA density of 0.18 or less appears to be an optimal range.

What are age-specific reference ranges for serum PSA?

• The usage of age-specific PSA ranges for the detection of prostate cancer is useful in avoiding needless investigations in aged men with enlargened prostate glands.
• The median PSA level for men whose age is between 40 to 49 years is 0.7 ng/mL and for men between 50 to 59 years is 0.9 ng/mL.
• Not all research findings have agreed that this is better than simply using a level of 4.0 ng/mL as the best normal level.
• However, the increase in the prostate levels because of the age factor and the idea of adjusting the cut-off values based on age have helped in reducing unnecessary prostate biopsies in aged men to improve early prostate cancer detection.

What is the accuracy of the PSA test?

• One of the limitations of the PSA test is that it is not specific to prostate cancer and it may be affected by numerous commonplace conditions, including the benign growth, irritation, and an infection of the prostate.
• Moreover, the PSA test results may vary depending on the type of testing equipment used.
• One study has shown that 25% of men who had an initial PSA result between 4 ng/mL and 10 ng/mL had a normal test result when the test was repeated again.

What is the cost of the PSA test?

• The PSA blood test is most often covered by the insurance, especially, for men aged 50 years or more.
• However, as the test is conducted in the doctor’s office during the visit to the doctor, there may be an additional charge of approximately $25 to $100 for the visit.