PSA (Prostate-specific antigen)

What is PSA?

PSA is a tissue-specific glycoprotein produced by epithelial cells of the prostate. PSA can be found in the cytoplasm of the prostate duct epithelium and in the secretions within the ductal lumen. Under normal conditions, the concentration of PSA in serum is very low but increases in the presence of prostate diseases.

What causes elevated PSA levels in men?

Experience from the Men’s Clinic of the University of Tartu indicates that elevated PSA levels above age-adjusted norms are most commonly caused, in roughly equal proportions, by prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer. For this reason, it is essential to exclude prostatitis in all men with elevated PSA levels before proceeding with prostate cancer investigations. The only evidence-based method for this is examination of prostate secretion. In many cases, treatment of prostatitis leads to normalization of PSA levels, helping to avoid nearly 40% of unnecessary prostate biopsies.

Prostate size can be assessed indirectly via digital rectal examination; however, prostate ultrasound provides more accurate results.

Indications

• Diagnosis of benign prostatic hyperplasia (BPH)

• Early detection of prostate cancer

• Monitoring patients diagnosed with prostate cancer

• Evaluation of the effectiveness of prostate cancer treatment

PSA is a first-line tumor marker used in the diagnostic evaluation of prostate cancer. PSA levels in blood are elevated in patients with prostate cancer, benign prostatic hyperplasia, or inflammatory conditions of the urinary tract.

Men with PSA values below the age-specific median have a low risk of developing prostate cancer, and PSA testing may be repeated after 4 years. In men over 75 years of age with PSA levels below 3 ng/mL, further PSA monitoring is generally not necessary, as the risk of death from prostate cancer is very low. The risk of cancer is higher in men whose PSA level exceeds twice the age-specific median.

PSA levels should not be used to determine the stage of prostate cancer.

Measurement of PSA concentration is also used to detect recurrence of prostate cancer in patients who have undergone surgical or medical treatment. The first PSA test is recommended one month after surgery.

PSA testing can be added to all Terviseuuringud.ee packages.

Health Check packages
Recreational Athlete packages