10 Things That Can Affect a PSA Test

By now, most men know that the prostate specific antigen (PSA) test is the first step in diagnosing Prostate Cancer. The PSA test measures the amount of prostate specific antigen in the blood. The prostate gland releases PSA into a man’s blood. A healthy man will have a very low level of PSA in his blood, but the level increases as a man gets older.

There has been much discussion on whether the PSA test is accurate or even relevant enough to perform on a man in diagnosing Prostate Cancer. One of the biggest arguments is that PSA levels can be elevated for many other reasons. It is estimated that only 25-35% of men who have biopsies due to an elevated PSA level actually have Prostate Cancer. The reasons for the false positives in PSA are many and include:

Benign Prostatic Hyperplasia (BPH): As men get older, many develop this very common, noncancerous enlargement of the prostate. This results in a change in urinary flow and leads to such symptoms as constant urination, the need to urinate suddenly, frequent urination during the night and difficulty emptying the bladder completely. By age 60, roughly 50% of men will have some signs of BPH. By age 85, about 90% of men show signs of BPH.

Age: Older men will notice a trend in higher PSA levels simply by the fact that they have gotten older. In the past, researchers have suggested adjusting PSA levels in older men, but some believed that this may present a problem in detecting cancers.

Prostatitis: An infection or inflammation of the prostate gland. Like with BPH, any enlargement of the prostate will affect PSA levels. The symptoms of prostatitis are also similar to BPH but can also include pain in the lower abdomen or low back area.

Ejaculation: Many doctors suggest that men abstain from ejaculation for two days before testing as it can cause a spike in PSA levels. In the results of a study to show the affect of ejaculation on PSA levels, after 24 hours, 40% of men showed a PSA level above baseline levels.

Medication: Medications like finasteride and dutasteride used for treating BPH or baldness, respectively, may cause PSA levels to decrease by as much as 50% or more. A 2008 study also reported that use of nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen may also decrease PSA levels.

Herbal Mixtures: Herbs that are sold as a dietary supplement for prostate health can mask an elevated PSA level.

Obesity: Researchers from the University of Texas found that men who are obese have lower PSA levels. This makes detecting cancer in obese men difficult as the PSA results are not accurate. In some cases, a diagnosis may come well after the disease has spread.

Injury: An injury to the prostate area, whether it is minor or more severe, can sometimes affect PSA levels.

Digital Rectal Exam: This type of exam is performed when a doctor inserts a lubricated glove into the rectum in order to feel if there are any abnormalities on the prostate. However, touching the prostate can cause elevated PSA levels. For this reason, this exam should be performed after a PSA test.

Because of these affecting factors, new research is being done to either change the way testing is done for Prostate Cancer or not relying solely on the PSA test when reaching a diagnosis. What many men need to understand is that the PSA test is necessary in determining whether further testing needs to be performed. If a man has an elevated PSA level, then further testing must be done.

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