Men generally relate PSA (prostate-specific antigen) to prostate cancer, and a high PSA to a higher likelihood of developing the disease. However, a high PSA does not always mean prostate cancer.
How high is too high?
Determining the level at which PSA is considered too-high is challenging, as experts disagree on this matter. One Danish study spanning 28 years analyzed blood samples from 4,383 healthy men. They found that the 10-year absolute risk of developing prostate cancer was about 11 to 22 percent for men whose PSA level ranged from 4.01 to 10.0 ng/mL and approximately 37 to 79 percent for those with a PSA level above 10.0 ng/mL. A level of 10.0 ng/mL is often considered the borderline between lower and higher risk of developing the disease. However, this number should only be used as a guide, as every man’s situation is different.
Does a high PSA mean prostate cancer is present?
A high PSA may indicate the presence of prostate cancer, but there are numerous other factors that can cause elevated PSA levels unrelated to cancer. An enlarged prostate, prostatitis, ejaculation within 24 to 48 hours before the PSA test, urinary tract infections, recent utilization of a urinary catheter, or undergoing a digital rectal exam within the past few days could all contribute to an increased PSA score. If your test returns a high reading, it is advisable to undergo a second test four to six weeks later to confirm the initial results since PSA levels can fluctuate.
Is there a PSA level where prostate cancer risk is non-existent?
The Cleveland Clinic and other experts concur that “there is no PSA level below which the risk of cancer is zero.” For example, the Danish study discovered that men with a PSA of 1.0 ng/mL or less still faced minimal risk (0.6 to 1.5 percent) of developing the disease.
What are other risk factors for prostate cancer?
Two men with identical PSA levels may have very different chances of developing prostate cancer, based on other risk factors. These include having a history of prostate cancer in the immediate family (father, grandfather, or sons), being African-American or Caribbean of African descent, older than 65, genetics (some gene shifts are associated with an increased risk), a diet high in animal products, and residing in North America, Australia, northwestern Europe, and the Caribbean.
While it’s essential to stay informed about PSA levels, it’s also critical to consider other risks in preventing prostate cancer and focusing on overall health. Adopting healthy habits such as maintaining a balanced diet, exercising regularly, getting regular check-ups, and discussing any concerns with your healthcare professional can be beneficial not only for your prostate health but your overall well-being.
