PSA
Prostate Specific Antigen
What this test measures
PSA is a protein made by the prostate gland in men. Higher levels can sometimes be a sign of prostate problems, including prostate cancer. However, PSA can be raised for many reasons.
Understanding the numbers
Typical range: Below 4.0 µg/L (age-dependent)
Normal levels increase with age. Lower thresholds apply for younger men. Results need careful interpretation in context.
- Normal (50-59): 0–3 µg/L
- Age-overlap (60-69): 3–4 µg/L
- Raised (over 70): 4–5 µg/L
- Above age-adjusted threshold: 5–10 µg/L
- Markedly raised: 10–20 µg/L
Key numbers
- 3.0 µg/L — Men 50-59 — refer on 2-week cancer pathway
- 4.0 µg/L — Men 60-69 — refer on 2-week pathway
- 5.0 µg/L — Men ≥70 — refer on 2-week pathway
- 10 µg/L — PSA >10 — higher cancer probability; urgent MRI pathway
NICE NG12 / PCRMP age-adjusted thresholds in UK primary care: ≥50-59 PSA ≥3 µg/L; 60-69 ≥4 µg/L; ≥70 ≥5 µg/L triggers a 2-week urology referral. PSA can be raised by UTI, recent catheterisation, prostatitis, cycling, ejaculation in the previous 48h, and benign prostatic enlargement — repeat and check context before referring.
Ranges can vary slightly between laboratories — your report may show slightly different numbers. This page does not read or interpret your result; your GP looks at it alongside your history and other tests.
What a higher-than-normal result can mean
- Does not always mean cancer – most men with raised PSA do not have cancer
- Can be raised by an enlarged prostate (very common as men age)
- Prostate infections or recent cycling can also raise PSA
- Your GP may recommend more tests or monitoring
Questions you could ask your GP
- What might be causing my raised PSA, and what are the next steps?
- Do I need to be referred for further tests such as an MRI scan?
- Should I have a repeat PSA test before any further investigation?
- What are the pros and cons of having a prostate biopsy?
Example stories
These are made-up examples to show how results are talked about in real appointments. They are not real patients.
Raised PSA on a requested check
Eric asked for a PSA after his brother was diagnosed with prostate cancer. PSA was 5.8. No urinary symptoms, no UTI, no recent cycling.
What the GP said: “This is above the age-adjusted threshold. I'll refer you on the 2-week urology pathway for assessment — usually an MRI first and then a biopsy only if the MRI is abnormal.”
What happened next: MRI showed a suspicious area; targeted biopsy confirmed Gleason 3+4 cancer. Eric chose active surveillance and remained stable at two years.
A PSA above the age-adjusted threshold warrants referral — but that doesn't mean cancer, and even if cancer is found, many men don't need immediate treatment. Modern pathways use MRI first to reduce unnecessary biopsies.
PSA raised from a UTI
Ranjeet had a UTI. PSA was 7.4 during that illness. Baseline was unknown.
What the GP said: “UTIs and prostatitis can markedly raise PSA for weeks. Let's treat the infection, then repeat PSA six weeks later before deciding on referral.”
What happened next: After antibiotics and 6 weeks, repeat PSA was 1.8. No referral needed.
A raised PSA during or soon after a urinary infection can mislead. Always check context — UTIs, catheters, cycling, recent ejaculation — and repeat after treatment before referring.
Marked rise — advanced disease
Bernard had back pain and weight loss. PSA 48. Back X-ray showed sclerotic lesions; MRI and biopsy confirmed advanced prostate cancer with bone metastases.
What the GP said: “Unfortunately this PSA and the scan findings point to advanced prostate cancer. Urology and oncology will see you urgently — there are effective treatments that can control it for years even at this stage.”
What happened next: Bernard was started on hormone therapy; PSA fell to 1.5 and his bone pain improved.
Very high PSA, especially with bone pain, points to advanced disease. Treatment with hormone therapy can often achieve years of disease control even when cure isn't possible.
Long-term benign prostatic enlargement
Fred's PSA had been sitting around 4.5-5.0 for five years. MRI two years ago was benign. He had an enlarged prostate and took tamsulosin.
What the GP said: “Your PSA is above the under-70 threshold but just below the over-70 threshold (5.0), and it's been stable for years with a benign MRI. We'll keep the same yearly monitoring.”
Benign prostatic hyperplasia (BPH) commonly raises PSA. Stable, slowly rising PSA in a man with known BPH and prior benign imaging often needs watching rather than repeated referral.
Before you act on anything here
This page is general information, written to help you understand — it is not personal medical advice and it cannot tell you what is right for you. Talk to your own GP, pharmacist or nurse about your own health.
- Need help now but it's not an emergency? Call NHS 111 or use 111.nhs.uk.
- Emergency? Call 999 or go to A&E.