Detecting Prostate Cancer. In the past, doctors typically considered PSA levels of 4.0 or below to be normal. If levels were above 4.0, doctors would consider that to be a red flag for cancer and order a biopsy . In recent years, however, doctors have come to understand that there is no real "normal" PSA value.
Screening may be considered in men ages 55 to 69 with the knowledge that it will prevent about one cancer death for every 1,000 men screened. Expert guidelines don't recommend PSA screening in men 70 and older. Because of their more limited lifespan, these men are less likely to benefit from early detection of low-risk cancer.
The normal range depends on your age. A PSA above the typical range may indicate the possibility of prostate cancer. However, two-thirds of cases of elevated PSA are due to noncancerous conditions such as prostatitis and BPH. A DRE is generally conducted by a urologist to feel the prostate. While DRE is no longer recommended as a routine test
Watch on Who can have the PSA test? If you are over 50, you can ask your GP for a PSA test. GPs do not routinely offer PSA testing as part of a general health check, or if you do not have any symptoms. If you ask for a PSA test, your GP will advise you to think carefully about the benefits and disadvantages.
Both guidelines recommend men are counselled on benefits and harms to help them choose whether or not to have a PSA blood test. The guidelines recommend different PSA thresholds that should trigger a referral for further investigation. For example, NICE recommend a PSA threshold of more than 3.5ng/ml for men aged 50-59; PCRMP recommend a PSA
When total PSA concentration is above 10.0 ng/mL, the probability of cancer is high and prostate biopsy is generally recommended. The total PSA range of 4.0 to 10.0 ng/mL has been described as a diagnostic "gray zone," in which the free PSA:total PSA ratio helps to determine the relative risk of prostate cancer (see table).
Medically reviewed by Mark Pomerantz, MD. Prostate-specific antigen, or PSA, is a protein naturally produced by the prostate gland in men.Because prostate cancer can increase the level of PSA in the blood, many doctors and professional organizations recommend that men over age 50 receive a PSA test in conjunction with a digital rectal exam to help detect the disease as early as possible. A prostate-specific antigen (PSA) test. Urgent referral should be considered if a person's PSA level is above the threshold for their age (for example, more than 4.5 in a person aged 60-69 years). The person's preferences and any comorbidities should be taken into consideration when making the decision. Prostate-specific antigen (PSA) is a protein produced by cells in your prostate gland. A PSA test measures PSA levels in blood, and normal results should be under 4.0 ng/mL. PSA levels above this threshold should be investigated because it may indicate prostate cancer, although other factors that might increase PSA levels include: an enlarged Prostate cancer is the most frequently diagnosed cancer in 112 countries and the leading cause of cancer death in 48 countries.[1] It is the fifth leading cause of male cancer-related deaths worldwide, with more than 1.4 million newly diagnosed cases and 375,304 deaths reported annually.[2]

The age-specific PSA reference ranges are as follows: 40-49 years, 2.15 ng mL −1; 50-59 years, 3.20 ng mL −1; 60-69 years, 4.10 ng mL −1; 70-79 years, 5.37 ng mL −1. The results indicate that the ethnic differences in PSA levels are obvious. The currently adopted Oesterling's age-specific PSA reference ranges are not appropriate

How is age associated with PSA levels? The relation between age and PSA levels has been well documented. As men age, the serum PSA levels also increase. Presently, amongst men of all ages, a single differentiation between normal and increased PSA value of 4.0 ng/mL is used as a signal for biopsy.

Objective: To describe values of serum prostate-specific antigen (PSA) in older men without diagnosed prostate cancer, categorised by age and country of birth, and to describe self-reported prostate cancer screening. Design, participants and setting: A cohort study (the Concord Health and Ageing in Men Project) involving a representative sample of 1434 eligible community-dwelling men with no

gland will expectedly release more PSA. This leads to a normal age-related rise in serum PSA concentrations. There is an age-related rise in the upper reference limit from 2 microgram/L in young men to up to 9 microgram/L in the very old (Fig. 1). The age-related upper reference limit of PSA maintains a 95% specificity across all age groups. .