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PSA Test Values Have Been Increasing With Year. Should I Be Worried?
Question: I have had a Prostrate exam for the last 3 years and nothing. But my PSA although is low has been increasing ever so slightly each year for the last 4 years. Like about .50 points. Is there any reason for alarm? Isf so what should?Cannot get PSA test results to you but can tell you that it has been rising from a very low, up about 5% each year for the past 4 years....is there any reason for alarm even though I am way under the threshold (range)?
Brief Answer:
Please find detailed answer below
Detailed Answer:
Hi Ronjsellers,
Thanks for writing in to us.
I have read through your query in detail.
Most doctors in the United States use 4.0 nanograms per milliliter (ng/mL) as a cutoff, considering results below that as normal and higher values as abnormal. But since PSA values tend to rise with age, even in healthy men, other authorities have proposed a range of normal values adjusted for age.
A proposed age-adjusted PSA reference range
Age group Proposed normal PSA range
40 – 49 0 –2.5 ng/mL
50 – 59 0 – 3.5 ng/mL
60 – 69 0 – 4.5 ng/mL
70 –79 0 – 6.5 ng/mL
The 0.5 units increase in PSA is termed PSA velocity (PSAV) and PSAV risk count testing may provide a more effective way for physicians to screen men for clinically significant prostate cancer. The new PSAV risk count screening works by monitoring fluctuations in PSA levels over time to analyze a man’s risk of prostate cancer, instead of relying on just one PSA test result to assign prostate cancer risk. The risk count is calculated by counting the number of times in a row that the PSA level in the blood increases by 0.4 ng/mL. If PSA goes up by more than 0.4 units multiple years in a row, the risk count rises, indicating the patient has an increased risk of aggressive prostate cancer. For example, a man who has a PSA screening for two years in a row would be given a “2” risk count if his serial PSA velocity measurements increased by more than 0.4 units, a “1” risk count if there was only one increase by more than 0.4 units, and a “0” risk count if there was no increase by more than 0.4 units.
In the study, researchers showed PSAV risk count could improve the specificity of screening for prostate cancer and advanced stages of the disease. Researchers evaluated 18, 214 men undergoing prostate cancer screening, 1,125 of which were diagnosed with the disease. The study results show sustained rises in PSA levels over time indicate a significantly greater risk of prostate cancer and more aggressive disease. In the study, a risk count of “2” was associated with a greater than 8-times risk of prostate cancer and a 5-fold greater risk of aggressive disease. The authors conclude risk count screening may be useful in diagnosing aggressive prostate cancer earlier while possibly reducing unnecessary biopsy as well as the over-diagnosis and resulting overtreatment of low-risk prostate cancer.
I hope this answers your query.
Do write in in case of doubts.
Regards,
Dr.Vivek
Please find detailed answer below
Detailed Answer:
Hi Ronjsellers,
Thanks for writing in to us.
I have read through your query in detail.
Most doctors in the United States use 4.0 nanograms per milliliter (ng/mL) as a cutoff, considering results below that as normal and higher values as abnormal. But since PSA values tend to rise with age, even in healthy men, other authorities have proposed a range of normal values adjusted for age.
A proposed age-adjusted PSA reference range
Age group Proposed normal PSA range
40 – 49 0 –2.5 ng/mL
50 – 59 0 – 3.5 ng/mL
60 – 69 0 – 4.5 ng/mL
70 –79 0 – 6.5 ng/mL
The 0.5 units increase in PSA is termed PSA velocity (PSAV) and PSAV risk count testing may provide a more effective way for physicians to screen men for clinically significant prostate cancer. The new PSAV risk count screening works by monitoring fluctuations in PSA levels over time to analyze a man’s risk of prostate cancer, instead of relying on just one PSA test result to assign prostate cancer risk. The risk count is calculated by counting the number of times in a row that the PSA level in the blood increases by 0.4 ng/mL. If PSA goes up by more than 0.4 units multiple years in a row, the risk count rises, indicating the patient has an increased risk of aggressive prostate cancer. For example, a man who has a PSA screening for two years in a row would be given a “2” risk count if his serial PSA velocity measurements increased by more than 0.4 units, a “1” risk count if there was only one increase by more than 0.4 units, and a “0” risk count if there was no increase by more than 0.4 units.
In the study, researchers showed PSAV risk count could improve the specificity of screening for prostate cancer and advanced stages of the disease. Researchers evaluated 18, 214 men undergoing prostate cancer screening, 1,125 of which were diagnosed with the disease. The study results show sustained rises in PSA levels over time indicate a significantly greater risk of prostate cancer and more aggressive disease. In the study, a risk count of “2” was associated with a greater than 8-times risk of prostate cancer and a 5-fold greater risk of aggressive disease. The authors conclude risk count screening may be useful in diagnosing aggressive prostate cancer earlier while possibly reducing unnecessary biopsy as well as the over-diagnosis and resulting overtreatment of low-risk prostate cancer.
I hope this answers your query.
Do write in in case of doubts.
Regards,
Dr.Vivek
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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