Typical PSA levels vary by age. A PSA level that’s higher than typical may indicate prostate cancer, but not always. Likewise, a low PSA level doesn’t necessarily mean you don’t have prostate cancer.
Your prostate-specific antigen (PSA) levels should usually be pretty low. PSA is a protein your prostate gland produces. High levels of PSA circulating in your blood may indicate prostate cancer.
Experts consider PSA levels below
What doctors consider a typical PSA level may vary based on your age and other factors. When diagnosing prostate cancer, a PSA test is just one of several diagnostic tools a doctor will use.
Read on to learn more about how your PSA levels may differ based on your age. We’ll also review other factors that may affect your PSA levels and what to expect if your PSA test results are high.
Language matters
In this article, we talk about the risk of prostate cancer in people assigned male at birth. Here, we use “men” to reflect a term that has been historically used to gender people. It’s important to note that not everyone assigned male at birth identifies with the label “man.”
While we aim to create content that includes and reflects the diversity of our readers, specificity is key when reporting on research participants and clinical findings.
The studies and surveys referenced in this article did not include data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.
PSA levels can vary based on your age. There’s
The recommended
| Age (years) | PSA upper limit (ng/mL) |
|---|---|
| 40–49 | 2.5 |
| 50–59 | 3.5 |
| 60–69 | 4.5 |
| 70–79 | 6.5 |
Even if you’re not at the upper limit, a doctor may still order further testing based on your symptoms, history, or other factors.
It’s also important to note that experts generally agree upon these values for white people.
How often does a high PSA level indicate prostate cancer?
In a 2018 study, using upper limits of 3 or 4 ng/mL, 9–33% of people with high PSA levels ended up with a confirmed prostate cancer diagnosis.
Some factors that can affect your PSA levels (and even make them appear lower on a PSA test) include:
- the size of your prostate gland
- having had a recent prostate biopsy
- having had a recent procedure to look inside your bladder or remove bladder cancer (cystoscopy)
- having an ejaculation within the 48 hours before testing
- smoking or
tobacco use - inflammation of your prostate gland from a bacterial infection (prostatitis)
- enlargement of your prostate gland due to noncancerous tissue, or benign prostatic hyperplasia (BPH)
- having a urinary tract infection (UTI), especially if you have
BPH or prostate cancer too - taking certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), statins, or diuretics for high blood pressure
- taking medications that treat BPH and lower PSA levels, such as finasteride or dutasteride
If your PSA levels are high, a doctor may order another test to compare the results and confirm that your PSA levels are actually high. If you take two PSA tests that show high levels, the doctor may ask to perform a digital rectal exam (DRE) to feel your prostate gland for any lumps or abnormal tissue.
If they don’t find any abnormal tissue or growths, the doctor will likely ask you to take another PSA test in a few months and recommend another DRE to keep observing your prostate gland. This process is called watchful waiting (or active surveillance). It helps the doctor closely monitor your prostate for any changes.
If the doctor finds irregular tissue or growths, they may order imaging tests to get a detailed view of your prostate and the surrounding area. This can include a prostate ultrasound or magnetic resonance imaging (MRI).
In some cases, the doctor may also take a prostate biopsy (or tissue sample) to test your prostate tissue for the presence of cancerous cells. This involves inserting a needle into your prostate through your rectum or perineum to extract a small amount of tissue they can look at using a microscope.
Imaging and biopsy can help the doctor confirm a diagnosis of prostate cancer. Imaging along with PSA level results can also help determine what stage of prostate cancer you’re in:
- Stage 1: Cancerous cells are found on only one side of your prostate.
- Stage 2: Cancerous cells have spread throughout your prostate but not beyond it.
- Stage 3: Cancerous cells are found in your prostate and some surrounding areas, such as your bladder or rectum.
- Stage 4: Cancerous cells have spread beyond your prostate to surrounding organs and lymph nodes.
Can I still have prostate cancer if my PSA levels are low?
Having high PSA levels isn’t the only sign of prostate cancer. Your PSA levels can still be low — even below 0.5 ng/mL — if you have prostate cancer.
That’s why a doctor will usually recommend other tests besides a PSA test to diagnose prostate cancer, especially if you’re experiencing other symptoms or are at high risk.
A 2020 study of more than 33,000 men between 55–74 years old found that Black men were at an especially high risk of aggressive prostate cancer even with PSA levels under 1 ng/mL.
Doctors usually consider PSA levels below 4 ng/mL typical if you’re between 40–70 years old. But what’s typical may vary by age and other individual factors.
Still, even low PSA levels may not accurately indicate whether or not you have prostate cancer. Your PSA levels are just one of several measurements a doctor might use to diagnose prostate cancer.
Getting regular PSA screenings when you’re older than 40 years of age can help you establish baseline PSA levels that are typical for you. This can help a doctor notice if your PSA levels start to rise above your baseline, especially if they rise