PSA is the abbreviation for the prostate-specific antigen. It is a protein produced in the cells of the prostate.

It is measured with a blood test

• as a tumor marker in the prostate cancer screening,
• for the tumor staging (assessment of the extend of the tumor disease and determination of the tumor stage for planning the therapy)
• as part of the therapy control and
• in the tumor aftercare

PSA should be measured from the age of 45 as part of cancer prevention. In men with a positive family history for prostate cancer, PSA can be measured as early as the age of 40.
Reference range of PSA:

40 to 49 years	< 2,5 ng/ml(ug/l)
50 to 59 years	< 3,5 ng/ml(ug/l)
60 to 69 years	< 4,5 ng/ml(ug/l)
70 to 79 years	< 6,5 ng/ml(ug/l)

Between 4 and 10 ng/ml (ug/l) is the borderline zone. Values may vary from lab to lab depending on the method. Therefore, the laboratory reference value should be always applied.

An increase in total PSA almost always indicates prostate disease. However, it does not always have to mean prostate cancer. The PSA is also elevated in benign prostate enlargement (benign prostatic hyperplasia), prostate inflammation or prostatic infarction (very rare event with damage of the prostate tissue due to interruption of the perfusion).

The PSA can also be temporarily elevated after mechanical manipulation during a digital rectal examination. But then it turns normal during the control measurement.

However, an increase in the total PSA does not allow conclusions to be drawn about a benign or malignat etiology.

The quotient of free PSA and total PSA provides more information about this.

PSA exists in free and bound form. Both together are measured as total PSA. Determining the percentage of free PSA in total PSA allows the distinction between benign enlargement of the prostate and prostate inflammation and prostate cancer. The free PSA/ total PSA ration is given as percentage.

< 15%	Suspected prostate cancer. Further investigation (biopsy) necessary.
15%-20%	Borderline. Follow-up monitoring recommended.
> 20%	Prostate cancer unlikely. Usually benign changes of the prostate.

Disclaimer: The calculator doesn’t allow to confirm or exclude any prostate disease. The correct (suspected) diagnosis can only be done by a doctor. (calcolatrice)