High, Low, or Normal? What PSA Prostate Test Numbers Mean

In 2025, nearly 15,000 more American men will be diagnosed with prostate cancer than in 2024, the American Cancer Society projects. For perspective: That’s more than the population of downtown Cincinnati. And it represents a steady rise in annual cases of prostate cancer dating back to 2014.

A “normal” PSA prostate test could change that. But what is considered a normal PSA result?

The PSA (prostate-specific antigen) test screens for the presence of cancer by measuring how much antigen, a protein, your prostate gland makes. Antigens can signal if something potentially harmful is in your blood. Historically, medical experts considered a normal PSA reading as anything below 4 nanograms of antigen per milliliter of blood.

However, ongoing research suggests many variables can influence that “normal” level. These variables include age, family history, and more, which we will get into shortly. But the upshot is this: What’s considered a high PSA for one man might actually be low for another.

Why Now Is an Opportune Time for a PSA Prostate Test

If you haven’t gotten a PSA prostate test yet, or it has been a few years since your last, June is a good time to schedule one because it’s Men’s Health Month, a calendar event that can serve as an annual reminder to take preventive care of your whole self every year.

If that’s not a good enough reason, maybe this is: Those nearly 15,000 additional prostate cancer cases predicted in 2025 will bring the total to nearly 314,000 men. Of them, 35,770 are expected to die.

This is regrettable because the survival rate of prostate cancer is very high when detected and treated early. 

PSA Prostate Test Basics: The Why and How

PSA is protein made by all your prostate cells, both healthy and potentially cancerous ones. So if your PSA level rises by even less than one point in one year, it could be a sign of abnormal cancer cell proliferation. 

Generally, anyone with a prostate has a 12% chance of developing prostate cancer at some point in his life and those chances increase as you age. 

That’s why the timing of your first PSA test is so important. The sooner you get screened, the more likely all your prostate cells are healthy to establish an accurate baseline, or your unique “normal” PSA level. Your future PSA readings are then compared with this benchmark. 

If you are approaching 50, ask your urologist if now is the right time for a PSA prostate screening. Researchers advise men at high risk – African Americans and/or those with an immediate family history of prostate cancer – to schedule their first PSA prostate test as young as 40 or 45.

What to Expect From a PSA Prostate Test

As screenings go, a PSA prostate test is pretty routine – you give a blood sample at your doctor’s office. Lab technicians then observe the blood under a microscope to measure how much PSA is circulating in the sample. 

Physicians rely on PSA tests to detect prostate issues besides cancer as well, such as an enlarged prostate, or benign prostate hyperplasia (BPH). (PSA levels tend to rise as the prostate enlarges because there’s more cell tissue.) BPH is non-cancerous, but the enlarged tissue can block urine flow and lead to infections, bladder stones, and other issues. 

A PSA prostate test is typically performed along with a digital exam of the prostate, a procedure in which the physician inserts a lubricated, gloved finger into the rectum to feel around the prostate for abnormal lumps or hard spots. 

What to Consider in Your PSA Prostate Test Results

Like I said, no single threshold distinguishes a normal PSA test result from an abnormal one – a man with a reading of 3 might have prostate cancer, while a man with a reading of 9 might not. What matters is if the baseline rises by more than 0.75 in one year.

Certain variables and conditions besides cancer can cause your PSA level to climb. Among them: 

• Your general health
• Advanced age because conditions such as BPH are more likely to develop as you age, some physicians set a higher “normal” reading for older men
• A recent prostate biopsy
• A prostate infection or inflammation
• Recent ejaculation or vigorous exercise
• The size of your prostate
• Certain medications, including those for BPH

Preparing for Your PSA Prostate Test

You’ll want to steer clear of certain activities and conditions before your PSA prostate test. Among them:

• Do not ejaculate for two days before the test. Semen carries PSA and can send of it into the bloodstream.
• Avoid vigorous exercise, especially bike riding, for a couple days before the test (it can bump up PSA).
• Make a list of medications to take for your physician. 
• Do not get a PSA prostate test if you have a prostate infection or even a urinary tract infection. A UTI can elevate PSA levels.

If your PSA level is rises, we could recommend special imaging, such as an MRI, as well as a biopsy of the prostate tissue.

Based on these results, you and your doctor can determine the next steps for treatment. Options include active surveillance, surgical removal of tissue, radiation therapy, and hormone therapy, depending on the stage of cancer. 

Make a PSA Prostate Test a Normal Annual Event

Your PSA prostate test can help save you from becoming one of the 15,000 men expected to develop prostate cancer this year, and in coming years. Mark Men’s Health Month on your calendar as a reminder to schedule your annual PSA prostate test, and reduce the numbers over all.