The amount of PSA in your blood is measured in nanograms of PSA per millilitre of blood (ng/ml). PSA levels can range from 1 ng/ml to hundreds of ng/ml.
Your first PSA test result is often referred to as a baseline or marker result, it lays down what your PSA level is and for any further tests you have it provides a comparison. Unless the result is high, a one-off test is of little value, you should repeat the test once the baseline is known, how regularly depends on your result.
Doctors will look at the rate of a rising PSA (velocity) comparing it with prior test results. As the PSA level goes up, the chance of cancer being present increases.
Keep a record of your test results on the PCaSO PSA Record Card. Download a copy here
If you’re aged 50–59, your PSA level is considered raised if it’s 3 ng/ml or higher.
If you’re aged 60–69, your PSA level is considered raised if it’s 4 ng/ml or higher.
If you’re aged 70 or over, your PSA level is considered raised if it’s 5 ng/ml or higher.
Normal PSA level – Green letter If your PSA level is not raised, you are unlikely to have cancer, however, the PSA test doesn’t always pick up prostate cancer, about 15% of all men with a ‘normal’ PSA level (under 4 ng/ml) may have prostate cancer.
No immediate action is needed, although you may have further PSA tests in the future.
Information on the green letter will recommend when you next have a PSA test depending on your result, age, any previous results or any risk factors which you may have declared.
Slightly raised PSA level – Amber letter Two out of three men with a slightly raised PSA level will not have prostate cancer, but you might need further tests, including more PSA tests to exclude cancer.
The amber letter will advise you to contact your GP to arrange further tests and discuss the results.
Raised PSA level – Red letter This result is abnormal and outside the guideline range for a man of your age. It does not necessarily imply there is anything seriously wrong with your prostate but you are strongly advised to see your doctor, to repeat your PSA test, examine you and, if necessary, refer you to a specialist urologist possibly under the 2 week wait criterion, especially if the repeated PSA result remains above the limit for your age.
One out of three men with a raised PSA level will have cancer. The higher the level of PSA, the more likely it is to be a sign of cancer. Although the PSA test alone cannot tell you whether you have prostate cancer.
The red letter will also give you the following options:
1. We have an arrangement with GenesisCare who are offering a free 15 minute telephone appointment with a member of their Urology team. These appointments can usually take place within 24 hours. For further information click here
2. You will also find details of the RAPID trial at Imperial College London Hospital enabling you to be referred to Professor Ahmed and his team within two weeks following a referral from your GP. For further information click here
Your doctor may also suggest you have a digital rectal examination (DRE). This is an examination of the prostate gland, during which a doctor will insert a gloved finger into your rectum. You may also be required to undergo a prostate biopsy. Two out of three men who have a biopsy don’t have cancer.
The red letters are followed up after 6 months and the amber letters after 12 months.
At no time does PCaSO or anyone involved with the testing claim to diagnose cancer or any other ailment.