PSA Test - Prostate Specific Antigen (PSA) Screening, Price & Normal Range

Complete Guide to PSA Test

The PSA test helps measure the level of prostate-specific antigen in the blood. PSA is a protein naturally produced by prostate gland cells. Its levels may rise in conditions such as inflammation, benign enlargement, or prostate cancer. PSA level usually varies across a man’s life cycle and can be higher in case of prostate-related issues.

Keep reading to find out more about the PSA test, why and how it is performed, preparation before the test, pricing, and more!

Quick Highlights

What is the PSA Test?

The PSA test is a blood test for men to detect prostate-specific antigen levels in their blood. PSA testing is recommended based on individual risk assessment and shared decision-making between the patient and doctor, typically starting at age 50 for average-risk men or earlier (45 or 40) for high-risk groups.

This test detects the high level of PSA in a man’s body, which can lead to prostate cancer, prostatitis (inflammation or infection in the prostate gland), benign prostatic hyperplasia (enlarged prostate), etc.

In a male’s body, PSA can either be present freely or attached to specific blood proteins. Thus, doctors advise getting a free PSA test along with a total PSA test to better analyse the cause of a high PSA level.

Why is PSA Screening Performed?

The prostate antigen test helps understand the prostate health of a male individual. It is usually used to detect prostate cancer at an early stage, but it also helps detect other issues like inflammation or an enlarged prostate.

Here are some of the reasons why doctors recommend a PSA blood test:

1. Detecting Prostate Cancer at an Early Stage

It is one of the most common cancers in men which develops with age. Usually, there are no noticeable symptoms for prostate cancer in the beginning, and it develops slowly. With the PSA test, doctors can identify unusual changes at an early stage so that they can investigate the condition further.

2. To Investigate Urinary Problems

If an individual develops symptoms like weak urine flow, frequent urination, or pain when urinating, a PSA test is necessary. These symptoms are usually related to prostate changes, so a PSA test helps detect if these symptoms are caused by inflammation, infection, enlargement, or any other serious issues.  

3. To Monitorany Existing Condition

Individuals who are already diagnosed with BPH (benign prostate enlargement) or prostate cancer need to undergo a PSA antigen test to keep track of their condition. An increase or decrease in PSA levels helps understand how the affected individual’s prostate is responding to their lifestyle changes or treatment.

4. Follow-up After Treatment

PSA testing is one of the primary follow-up tools after a prostate surgery, medical therapy, or radiation. After treatment, PSA levels that are consistently low or undetectable may indicate remission. On the other hand, a progressive increase may imply that the prostate is becoming active again, allowing for early intervention.

5. General Screening or Checkup for Men above 40 Years

Doctors also recommend a PSA test for men above 40 or 50 years of age, even if they have no symptoms, as a routine checkup. This is usually recommended for individuals with risk factors like poor diet or obesity, family history of prostate cancer, sedentary lifestyle, etc.

What are the Symptoms or Conditions that Need PSA Testing?

If an individual has the following symptoms, it indicates prostate issues, and doctors may advise a PSA test in such a condition to ensure accurate diagnosis and treatment procedure:

• Painful urination
• Frequent urination
• Blood in semen or urine
• Back or pelvic pain
• Incontinence or an urgent urge to urinate

How is the PSA Blood Test Performed?

The following procedure is performed during a PSA test:

• Step 1: A laboratory technician will draw blood from the individual’s upper arm, using a needle.
• Step 2: They will send the blood sample to a laboratory to analyse the PSA level in the collected blood sample.
• Step 3: The individual may feel a slight pain while pricking the needle, but the pain won’t last more than a few minutes.     
• Step 4: The test does not require any special preparation except for avoiding sex indulgence one day before the test. This is because releasing semen can increase the PSA level, affecting the accuracy of the result.
  Note: If you are taking any herbal supplements or medications, inform your doctor before taking the test to avoid any effect on the result.
• Step 5: The laboratory will analyse the result and provide the report to the individual. It is necessary to make an appointment with a doctor for the correct interpretation of the result and understanding the prostate condition.

How to Prepare for a PSA Test?

Before getting ready for the PSA test, one should avoid activities and habits that can increase or reduce PSA levels artificially. Here are some of the preparation tips to follow:

• Consider avoiding ejaculation for 1-2 days before the test, as it can elevate the PSA levels temporarily.
• Though there are no such dietary restrictions, consider following the doctor’s advice in case of any other health conditions.
• Avoid vigorous physical activities like cycling before the test to avoid an inaccurate result.
• Medicines like 5-alpha-reductase inhibitors, which are used for the treatment of enlarged prostate, often lower the PSA level. So, if you are taking any such medicines or supplements, inform your doctor before the test, as it can influence the test result.
• If you are about to undergo any prostate procedures, consider scheduling the test before that, as it can affect your PSA levels temporarily. Make sure you are hydrated, as it makes the blood collection procedure smoother.

PSA Test Normal Range by Age

With age, the prostate increases in size, and so does the PSA. Doctors will interpret PSA based on age. PSA is measured in nanograms per millilitre (ng/mL). Typical age ranges are:

• Age 40–50 years: 0 to 2.5 ng/mL is considered normal.
• Age 50–60 years: 0 to 3.5 ng/mL is considered acceptable.
• Age 60–70 years: 0 to 4.5 ng/mL is average.
• Age 70 and above: 0 to 6.5 ng/mL is considered normal.

How to Interpret PSA Test Results?

The PSA test checks the prostate-specific antigen level in a man’s blood to detect the signs of inflammation, prostate stress, or other related conditions at an early stage. The interpretation of the test result goes as follows:

Usually, the test results have one of these four meanings:

• PSA 0-2.5 ng/mL: Very unlikely to be prostate cancer. The chance of cancer at this stage is low, and usually no more tests are needed.
• PSA 2.5 to 4.0 ng/mL: Falls in the normal range. If there are no other risk factors, the PSA is stable, and you are not on medication for BPH, a doctor may decide that no further tests are needed and recommend repeating the test at a later date.
• PSA >4.0 ng/mL: The doctor may want to do more testing to exclude benign causes, for example, a urinary tract infection, which can raise PSA.
• PSA 10 ng/mL or higher: This is a worrying level as it greatly increases the chances of prostate cancer.

A high PSA level does not always indicate cancer. Benign growth, inflammation, or even recent activity might raise levels. To confirm the cause, your doctor could advise repeating the test or doing more tests, like an MRI or biopsy.

What are the Risks or Side Effects of PSA Screening?

The PSA test includes some of the following risk factors:

• If you get a false positive result, you may need to undergo further unnecessary tests when PSA levels are high, without even having prostate cancer.
• A false negative can miss the detection of cancer even if the PSA test shows a normal range.
• Overdiagnosis of the condition can detect cancers that are slow-growing and may not cause any harm.
• Overtreatment can lead to unnecessary procedures that cause erectile dysfunction, incontinence, or other side effects.

What are the Benefits of PSA Screening?

Here are some of the notable benefits of a PSA test:

• Helps Detect Prostate Issues at an Early Stage: With a PSA blood test, doctors can detect prostate cancer at an early stage. This increases the scope of treatment, providing better outcomes and saving lives.
• Helps Plan the Treatment Accordingly: Tracking PSA levels helps patients with prostate cancer assess the effectiveness of their treatments and modify their care plans for optimal outcomes.
• Simple and Non-Invasive Procedure: It is a quick blood test which does not involve any invasive procedure. The process is generally well tolerated and offers easy access to prostate health monitoring.

What are the Factors that Affect the PSA Level?

Factors such as age, prostate size, recent ejaculation, infections, medications, and medical procedures affect PSA levels. Certain populations may have a higher risk of prostate cancer, which influences screening decisions. Men with small prostates tend to have low PSA levels, and men with large prostates tend to have higher PSA levels.

Who should get this test?

The following people can benefit from a timely PSA test:

• Men aged 50 years or older
• Men who have a family history of prostate cancer
• Men who have immediate male relatives with prostate cancer
• Men suffering from prolonged prostate or urinary problems

What is the Cost of PSA Screening in India?

In India, the approximate cost of PSA testing can vary based on the location or diagnostic centre. PSA test typically costs ₹500 to ₹1500, depending on city, diagnostic lab (private vs hospital), type of the test.  Does Health Insurance Cover PSA Tests?

A health insurance plan in India may cover the cost of a PSA test depending on the terms and conditions specified in the policy, including any waiting periods and limitations. However, the coverage for this varies depending on the provider, the conditions of the policy, and whether the PSA test is utilised for a diagnostic or routine preventative screening.

Therefore, to have a thorough understanding of the inclusions and exclusions related to the coverage of the PSA test, policyholders and those planning to obtain health insurance are advised to carefully examine the policy documentation or get in touch with the insurance provider.

Reader Information: This article is intended for general informational and educational purposes only. It should not be considered as medical advice, diagnosis, or treatment. PSA test results can vary based on individual health conditions, age, and other factors. Always consult a qualified doctor or healthcare professional for proper interpretation of test results and medical guidance.