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Understanding Your Test Results

Screening doesn’t show whether you have prostate cancer, only whether you need further testing.

Screening Tests

Prostate cancer screening consists of 2 examinations:

A physical exam of the prostate, the Digital Rectal Exam or DRE.
A blood test that measures levels of Prostate Specific Antigen or PSA.

These exams are done together to increase the accuracy of diagnosis.

DRE Test Results

Results of the DRE are described as either negative (normal) or suspicious (potentially indicating some abnormal growth). If the results are considered suspicious, consult your doctor about what to do next. Your doctor may want you to undergo further testing, even if your PSA level is considered 'normal'.

Annual Screening

If you are aged 40 to 45, are not African American, and do not have a family history of prostate cancer, and you are taking the test to determine a baseline PSA level for future comparison:

If your PSA level is greater than 0.6 ng/mL, you should start getting a PSA test every year.
If your PSA level is less than or equal to 0.6 ng/mL, you can wait 5 years until your next PSA test.

If you are African American, or have a family history of prostate cancer, you should start annual testing at age 45, regardless of PSA level.

PSA Test Results

The PSA level considered 'normal' varies depending on your age, and ethnicity.

If your PSA level has increase by 0.75 ng/mL or more over the past year, you should make an appointment to see your doctor, even if your PSA level is otherwise low. The change in your PSA level over time, or PSA velocity, is very important, as a rapid increase may indicate an aggressive case of the disease.

You should see your doctor if your PSA test results are above the following cut-off levels:

Body Mass Index, a measure of obesity, may also be a factor. The relationship between obesity and lower PSA levels may cause doctors to miss early prostate cancer cases in overweight men.

Elevated PSA levels do not necessarily indicate prostate cancer, only that you should undergo further testing or closer observation. Elevated PSA levels can also be caused by an enlarged prostate or prostatitis.

As PSA levels increase, so do the odds that it’s due to prostate cancer. About 25% of men with a PSA level from 4-10 have prostate cancer. About 67% of men with a PSA above 10 have the disease.

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