PSA (Prostate-Specific Antigen)
Assessment Stage: Baseline Assessment — where appropriate
Included in Future Health Assessment: Where clinically appropriate following shared decision-making
Partner: DHM Pathology
Provider: DHM Pathology
Approximate Cost: Medicare where eligible
What is it?
PSA is a protein produced by the prostate gland. A blood test measures the amount of PSA circulating in the bloodstream.
PSA may rise because of prostate cancer, but it can also increase with benign prostate enlargement, inflammation, infection, ejaculation, cycling and recent prostate procedures.
What does it measure?
Total PSA
PSA trend over time
Age-adjusted PSA interpretation
Free-to-total PSA ratio where indicated
Why is it important?
PSA testing may identify prostate cancer before symptoms develop. However, PSA is not cancer-specific, so an elevated result does not automatically mean cancer is present.
Australian guidance supports an informed decision about testing after discussing the potential benefits and harms. For men who choose screening, testing intervals depend on age, family history and previous PSA results. (Cancer Council Australia)
Who may benefit?
Testing may be considered for:
Men aged approximately 50–69 years
Men from around 40–45 years with a significant family history
Men with urinary symptoms
Men with a previously elevated PSA
Men at increased inherited risk of prostate cancer
What happens during the test?
A routine blood sample is collected.
An abnormal result may lead to repeat PSA testing, prostate examination, specialist review or prostate MRI rather than immediate biopsy.
Preparation
Where possible:
Avoid ejaculation for approximately 48 hours beforehand.
Avoid prolonged vigorous cycling immediately before testing.
Delay testing during a urinary infection or acute prostatitis.
Tell your clinician about recent catheterisation, prostate procedures or urinary retention.
Advantages
Simple blood test
May detect prostate cancer before symptoms develop
Useful for monitoring change over time
Can guide further investigation
Limitations
PSA can be elevated without cancer.
Some prostate cancers do not produce a marked PSA rise.
Screening may identify slow-growing cancers that would never have caused harm.
Abnormal results can lead to anxiety and further testing.
How Future Health uses this investigation
PSA is offered after discussing:
Age
Family history
Previous results
Urinary symptoms
Personal preferences
Potential benefits and harms of screening
Results are interpreted as a trend rather than as an isolated number.
Future Health Summary
PSA can contribute to earlier prostate cancer detection, but it should be used through informed, shared decision-making rather than as an automatic test for every man.