When is it useful to determine the PSA?

Determining the PSA value (Prostate Specific Antigen) is an important, but sometimes controversial subject in medicine.

PSA is a protein produced by the prostate. A small amount of PSA always enters the bloodstream. An elevated level can indicate prostate enlargement (benign), inflammation (prostatitis), or prostate cancer. However, PSA is not specific for cancer; it can also increase with harmless conditions.

A PSA level is only useful for symptoms that point to prostate problems, such as difficult or painful urination, a weak urine stream, blood in urine or semen, or pain in the lower abdomen or lower back. In such cases, PSA helps distinguish between benign enlargement, inflammation, or something malignant.

A PSA level test is also useful if prostate cancer is suspected due to abnormalities in the prostate during a rectal examination, where the prostate feels irregular or hard. A PSA level test is also useful if ultrasound or MRI reveals a suspicious picture.

But PSA is especially useful for monitoring prostate cancer. After treatment, PSA is measured regularly to detect recurrence.

Many scientific societies do not recommend routine PSA screening because PSA is often false-positive. Many men undergo unnecessary tests or treatments, with the risk of side effects (incontinence, impotence). Screening can only be useful in men with a close family history of prostate cancer.

Source: https://www.acpjournals.org/doi/10.7326/0003-4819-157-2-201207170-00459

Author: Prof. Dr. Dirk Devroey - Latest update: 2025-11-04 - Copyright: Clinifacts 2026