What is PSA?
PSA stands for prostate-specific antigen. It is a protein that is normally produced in the prostate gland and secreted into the seminal fluid. Small amounts leak out into the blood, where the level can be measured with a simple blood test taken from the arm.
The PSA level rises in several prostate diseases – not only in cancer. Infection and benign prostate enlargement also raise the level. Because the prostate often grows with age, the PSA level is on average somewhat higher in older men than in younger ones.
Men who have a normal PSA level and a prostate that feels normal on examination have a very small risk of having a serious prostate cancer.
Source: Prostatacancerförbundet (prostatacancer.se).
50–75 years
the ages at which men should mainly consider a prostate check
Prostatacancerförbundet
From 40 years
the test can be considered if a father or brother has had prostate cancer before the age of 55
Prostatacancerförbundet
Common questions about the PSA test
Who should take a PSA test?
A PSA test should always be taken where there are symptoms that raise a suspicion of prostate cancer. Beyond that, the test can be used as what is known as a prostate check, that is, to examine whether a man has a small prostate cancer even though he has no symptoms.
It is mainly between the ages of 50 and 75 that men should consider whether they should have a prostate check. Before the age of 50, prostate cancer is a rare disease. Men over 75 may well have a small prostate cancer, but if they have no symptoms it is unlikely that it will have time to develop into a serious disease during their lifetime.
Source: Prostatacancerförbundet (prostatacancer.se).
Should I take a PSA test if prostate cancer runs in the family?
Where there is heredity, other recommendations apply. Men who have a father or brother who was affected by prostate cancer at an unusually young age, before 55 years of age, can consider giving a PSA test as early as from the age of 40.
Source: Prostatacancerförbundet (prostatacancer.se).
Should all men check their PSA?
There is no universal answer to the question of whether a man should check his PSA. Advantages and disadvantages can be valued differently by different people, and according to the national care programme, men without symptoms who want a prostate check should be offered written information about both aspects.
Since 2018, the Swedish National Board of Health and Welfare has advised against a national screening programme for prostate cancer. In those regions that have organised prostate cancer testing, men in defined age groups are actively informed about testing.
Source: Prostatacancerförbundet (prostatacancer.se).
How does a PSA test work?
If you want to be tested, you contact your local health centre or a urologist to book an appointment. The test is an ordinary blood test taken from the arm.
What your level means depends on your age and on the size of the prostate. Read more about how the level is interpreted PSA levels.
What happens if the PSA level is raised?
A raised PSA level leads to a referral to a urologist for investigation. In most cases the first step is an MRI examination of the prostate, and after that a tissue sample may become relevant. This is how the investigation works, step by step Making a diagnosis.
It is the tissue sample that determines whether there is cancer and, if so, how aggressive it is. That assessment is made by a pathologist using Gleason grading – a method that is based on human judgement and that has known limitations Limitations of the Gleason method.
Can I get an independent assessment of my biopsy result?
If you have already received a biopsy result and feel unsure about the assessment, an independent analysis can give a more secure basis for the decision What is a second opinion?. The analysis is carried out on the tissue samples that have already been taken – you do not need to give new samples.
Do you have a test result you are wondering about?
We will go through what your material shows and what an independent analysis could add. The initial meeting is free of charge. If you feel afterwards that this is right for you, you can simply order a second opinion.
We have collected further questions and answers about diagnosis, analysis and second opinions separately Common questions.