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What is PSA Testing? What is it about? What are the medical indications for its performance? What are the standards for this study? The question is answered by the drug. Paweł Żmuda-Trzebiatowski.
What are the standards for PSA testing?
Good day. My name is Grzegorz, I’m 40 years old. I am a person who pays special attention to my health. I do not use stimulants or alcohol, I do physical activity and take care of my diet. I am also aware of the risks that may affect me, including prostate cancer. Of course, I would like to avoid it, but I know that many factors of its appearance do not depend on me. Therefore, I decided to undergo screening tests to diagnose prostate cancer.
I made this decision also because my uncle suffered from this cancer. So I did PSA tests. I’m waiting for the result now. However, I was very surprised that the doctor told me not to engage in any physical activity or sex on the day before the examination. Apparently this can distort the result, but is it true? I also read that PSA test standards are different depending on age. So my question is what are the PSA testing standards for my age group?
I will also ask if all laboratories have adopted the same PSA standards indicators? Does each have a different one? I will be grateful for your feedback.
The doctor explains what the PSA test standards are
Dear sir, it is generally accepted that total PSA concentration (prostate antigen) should not exceed 4.0 ng / ml. However, as you rightly pointed out, the standards are more restrictive and depend on the age of the man. For men aged 40-50 too the correct concentration of total PSA those that do not exceed 2.5 ng / ml are considered.
The older the patient, the less restrictive the norms are, and so in men aged 70-80 years, a value of up to 6.5 ng / ml is considered the norm. Some believe that the result in the range of 4.0-10.0 ng / ml belongs to such a gray area that makes interpretation difficult. PSA levels can rise in a variety of situations. Not only in the case of prostate cancer, but also in cases of its benign enlargement or inflammation.
The doctor was quite right to tell you that before the examination you should not have sex or intense physical activity – you should keep an interval of at least 48 hours, due to the possible disturbance of the result.
If prostate cancer is suspected, it is better to investigate beyond total PSA as well PSA free fractionwhich is a more sensitive diagnostic indicator. If the ratio of free PSA to total is less than 10 percent then the risk of cancer is very high, and if the ratio is greater than 25 percent then the probability is very low.
In the case of incorrect PSA result and per rectum examination, your urologist may order a prostate biopsy. Six sections are taken from each lobe of the gland (the prostate consists of two lobes) and then subjected to a histopathological examination.
In the case of men of your age, the indication for PSA control is increased risk of developing prostate cancerespecially when such a cancer has already occurred in the immediate family.
As for the standards adopted by the laboratory, the standards should be harmonized in all laboratories, but please be concerned, because the correct range of values is always given along with the result.
– Lek. Paweł Żmuda-Trzebiatowski
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