Causes of Elevated PSA

Most of us relate PSA blood test to prostate cancer, as it is used as a screening test for detecting the condition. This test is conducted to check the levels of prostate specific antigen (PSA) in blood. PSA is a protein produced by the prostate gland. Even though, the effectiveness of this test is still a much debated topic, most of the health experts resort to this diagnostic test for detecting not only prostate cancer, but other benign prostate conditions too. Let us understand more about this test, before starting with the various causes of elevated PSA.

PSA Blood Test Results

The normal PSA level in a healthy person is said to be below 4 ng/mL. PSA levels of 4 and above 4 ng/mL, may be indicators of prostate cancer. According to some health experts, this cutoff level is fine for older men, but, in case of younger men, normal PSA levels must be taken as 3 to 2.5. But, PSA test cannot be a conclusive proof for having or not having cancer, as men with any PSA level have a risk of cancer, but the only difference is that, those with elevated PSA levels have a very high risk. While interpreting the PSA test results meaning, the doctor must take into consideration, factors like, age of the person, the rate of PSA level increase during the last few years, etc. Another point that has to be taken into consideration is the ratio of free PSA to total PSA (the lower the level the greater the risk of cancer). Apart from cancer, PSA test results indicating increased levels of PSA may be an indication of other prostate conditions. Let us take a look at such causes of elevated PSA levels.

What Causes Elevated PSA?

So, high PSA levels may be an indication of problems other than prostate cancer. Even temporary elevation of PSA levels can be seen in certain cases. The following are some of the common causes of increases levels of PSA.

• As we all know, prostate cancer could be one of the elevated PSA causes. This cancer may not have any early symptoms, but, at later stages, the affected person may experience erectile problems, pain in the pelvic area and back and variations in urinary flow and frequency.
• One of the commonly found causes of elevated PSA in men, especially older men, is the condition called enlarged prostate (medically termed as benign prostatic hyperplasia). It has been observed that the chances of developing this condition increase with age and more than half of the men, who are above the age of 50, have this benign (not cancerous) condition, which causes difficulty in urination, changes in urine flow, etc.
• Even prostatitis or inflamed prostate gland (either caused by infection or other factors) is one among the elevated PSA causes. In this case too, the symptoms may be more concentrated on the urinary flow, frequency, etc. Painful urination, lower back pain, burning sensation during urination, pain in the pelvic area, hip, penis and scrotum is observed.
• There are various other conditions that can cause temporary rise in PSA levels. It has been observed that digital rectal examination (DRE) can cause such temporary rise. Even prostate biopsy may cause this. This is the reason why doctors go for PSA tests, before conducting DRE or biopsy.
• Another possible cause of elevated PSA levels is rigorous physical activity. Long and tedious bicycle riding may also lead to rise in PSA levels. It has also been noted that a PSA test done within 24 hours of ejaculation may show a rise in PSA levels.

This was an overview of the various causes of elevated PSA levels. As you must have seen, high PSA levels may be due to benign as well as malignant causes. In both cases, the test has to be repeated to diagnose the condition that has to be confirmed with screening tests like, biopsy, digital rectal exam, trans rectal ultrasound and blood tests for detecting infection.