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Health Check

PSA – Prostate marker

PSA is a blood test that reflects prostate activity and is used in the investigation of prostate issues and as part of prostate cancer diagnostics. An elevated value does not necessarily mean cancer—benign prostate enlargement and inflammation also raise PSA.

What is PSA?

PSA (prostate-specific antigen) is a protein formed in the prostate. The test is reported as total PSA and sometimes as free PSA, as well as the ratio between them, which facilitates interpretation at borderline values.

Why is PSA measured in a health check?

The test is relevant for men from about 50 years of age, earlier in case of heredity, and for symptoms such as frequent urges, weak stream, or nocturnal bathroom visits.

High and low values

High value: Elevated PSA can be due to benign prostate enlargement, prostate inflammation, urinary tract infection, cycling, or a recent examination—and in some cases, prostate cancer. An elevated value should always be followed up in healthcare.

Reference ranges differ between laboratories, sexes and ages and are stated in your result. The information here does not replace medical assessment.

How PSA is measured in a health check

PSA (prostate-specific antigen) is a protein produced in the prostate and measured in a standard blood test. The test requires no fasting, but several everyday factors can temporarily raise the value and make the result difficult to interpret. This is why there are clear recommendations before testing.

  • Avoid ejaculation for two days before the test
  • Avoid longer cycling one to two days before the test
  • Wait at least a few weeks after a urinary tract infection or prostatitis
  • Wait after catheter treatment or an examination of the prostate
  • Mention any medication for benign prostate enlargement, which can lower PSA

What an elevated PSA means — and doesn't mean

An elevated PSA means the prostate is affected, not that it's cancer. The most common causes are benign prostatic enlargement, which becomes increasingly common with age, and prostatitis. PSA also rises naturally with increasing age, which is why the value is assessed against age-adjusted limits.

For borderline values, the ratio between free and total PSA is used. A low ratio suggests the prostate should be investigated further, while a high ratio more often suggests benign enlargement. If needed, the doctor will supplement with an examination, an MRI scan and in some cases a tissue biopsy.

Who should consider PSA?

PSA in a health check is mainly relevant for men from around age 50, and earlier with a family history — especially if a father or brother had prostate cancer before age 65, or if there's known heredity in the family. With symptoms such as frequent urgency, a weak stream, nighttime toilet visits or blood in the urine, you should seek medical care regardless of the test result.

It's also worth knowing that PSA screening has both advantages and disadvantages. The test can detect disease early, but can also lead to investigation of conditions that would never have caused problems. The National Board of Health and Welfare (Socialstyrelsen) therefore recommends deciding after receiving information about both the benefits and the risks.

Follow-up over time

A single PSA value says less than the trend over time. With a normal value and no symptoms, a check every two to three years is a common rhythm for those who choose to follow their PSA. If you have a borderline value, it's usually repeated after a few weeks with the right preparation, since any temporary effect will then have had time to subside. Rising values between measurements are a more important finding than a single high result and should be assessed by a doctor.

Frequently asked questions about PSA

Does high PSA mean you have prostate cancer?

No. The most common causes of elevated PSA are benign prostate enlargement and inflammation. An elevated value means it needs further investigation, not that cancer is present.

What should be avoided before a PSA test?

Avoid cycling, hard training, sexual activity, and prostate examination in the days before the test, as these can temporarily raise the value. Also, wait until any urinary tract infection has healed.

What does the free/total PSA ratio say?

The ratio is used when total PSA is in the borderline range. A low ratio indicates that the prostate should be further investigated, while a high ratio more often indicates benign enlargement.

How should you prepare for a PSA test?

Avoid ejaculation and longer cycling in the days before the test, and wait a few weeks after a urinary tract infection. Otherwise the value risks being temporarily elevated.

Does a high PSA mean you have cancer?

No. The most common causes are benign prostatic enlargement and inflammation. An elevated value means the prostate should be assessed further, nothing more.

From what age is PSA relevant in a health check?

Usually from around age 50, and earlier with a family history of prostate cancer. With symptoms, you should seek medical care regardless of age.

Health checks that include PSA

PSA is included in 2 of Labkollen's health checks. Analysis name in the result: PSA fritt, PSA fritt/total, PSA total.

  • Man +

    49 markers

    Labkollens mest omfattande kontroll för män – inklusive testosteron, PSA och hjärt-kärlmarkörer.

    2 195 krMed prenumeration (årlig hälsokontroll): 1 756 kr

    See the test

  • Prostata

    3 markers

    PSA-prov för män som vill följa prostatavärden.

    549 krMed prenumeration (årlig hälsokontroll): 439 kr

    See the test

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Guides covering PSA

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Responsible for the content: Mathias Khemiri, Oftamed Sverige AB.

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