People with prostate cancer usually have elevated levels of prostate-specific antigen (PSA). However, other causes for high PSA levels can include older age and a person’s sexual activity levels.
Other health conditions may also cause an increase in PSA levels. In some cases, an elevated PSA is temporary and not a sign of a health problem.
Health conditions, lifestyle factors, and testing inconsistencies can all contribute to high PSA test results. A doctor can further discuss the reasons for elevated PSA levels with a person.
They will also decide whether delaying testing or planning additional tests might help them determine the cause of high PSA test results.
This article discusses eight noncancerous causes of high PSA levels, plus other symptoms that may indicate prostate cancer.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
Cells in the prostate gland produce PSA, and levels typically remain below
Most individuals with prostate cancer have PSA levels
These variations mean that a PSA test alone cannot rule out or diagnose prostate cancer. However, this test can identify whether a person has a higher risk of developing the disease.
Initial testing may include both a PSA test and a digital rectal exam (DRE).
During a DRE examination, a doctor inserts a finger into the rectum to check the prostate for anomalies.
If both of these tests suggest prostate cancer, the doctor will arrange for a biopsy to confirm the diagnosis.
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If a person has elevated PSA levels due to an underlying health problem, they may experience other symptoms. With this in mind, people should discuss high PSA levels with a healthcare professional.
Besides prostate cancer, other factors might contribute to high PSA levels.
People who are more than 50 years of age should speak with their doctor about their risk of developing prostate cancer. They can also discuss the benefits and risks of PSA screening for them.
Urologists commonly use age adjustment to put an elevated PSA in perspective for an older individual. For example, they consider a PSA of 4 as elevated for a 40-year-old individual but typical for someone who is 80 years old.
Additionally, the Prevention Services Task Force does not recommend prostate cancer screening for people above 70 years of age. Some data suggest that screening does not improve cancer survival rates and may result in false-positive results.
The diagnosis and treatment process may also lead to more negative effects than benefits for males older than 70 years.
Therefore, it is important for a person to discuss screening options with a doctor according to their family and personal medical history.
Prostatitis involves the inflammation of the prostate and can be a chronic problem. The condition may sometimes occur due to a bacterial infection.
People with prostatitis
Someone with prostatitis may experience the following symptoms alongside elevated PSA levels:
- difficulty and pain when urinating
- pressure in the rectum
- ejaculation problems
- changes in sexual function
Benign prostatic hyperplasia
Benign prostatic hyperplasia (BPH) is an enlarged prostate that
BPH does not increase the risk of cancer, but the symptoms can be similar to prostate cancer. A person with BPH will often experience irritation while urinating.
Medical procedures on the prostate
A recent prostate exam can cause false positives on a PSA test. Likewise, this can occur after inserting a urinary catheter or scope into the urethra.
For the most accurate results, a person should wait a few weeks after a medical procedure before undergoing PSA testing. Alternatively, they can have the PSA test before the procedure.
Urinary tract infection
A urinary tract infection (UTI) is an infection of the urethra or bladder that can cause PSA levels to rise.
Having a UTI can cause pain during urination, blood in the urine, or an inability to urinate. In most cases, a simple urine test can accurately diagnose a UTI.
Learn more about UTIs in males.
Cycling and doing other forms of vigorous exercise 1–2 days before a PSA test
A person may consider asking a doctor about exercise recommendations before scheduling a PSA test.
People who have scheduled a PSA test should tell their doctors about any prostate symptoms they may be experiencing. Changes in ejaculation or urination often indicate a problem with the prostate.
The following symptoms could indicate a prostate issue:
- rectal pain
- abdominal pressure
- signs of an infection
Learn more about whether frequent ejaculation can reduce a person’s risk of developing prostate cancer.
A person’s PSA levels may rise if their prostate experiences stimulation during sex or if they receive anal sex. A healthcare professional may recommend avoiding sexual activity for around a week before having a PSA test.
People who know that their PSA levels are high may find it helpful to seek the advice of a healthcare professional for further advice.
Prostate cancer may not cause any symptoms. However,
- erectile dysfunction
- blood in the semen or urine
- pain in the hip, pelvis, back, or ribs
- a reduced flow of urine
- problems urinating
- incontinence or increased urges to urinate
These symptoms are similar to those of other prostate conditions, including prostatitis and BPH.
A person with symptoms of a prostate issue will typically need additional testing to help with diagnosis.
Several factors can cause a person to have elevated PSA levels, including age, health conditions, certain medical procedures, and sexual activity.
Individuals should speak with a doctor if they are experiencing symptoms of prostate cancer or if they wish to find out more about PSA testing.
Can any of the above conditions become prostate cancer over time?
Out of everything listed in this article as causes of elevated PSA levels, only a few of them may increase the risk of prostate cancer.
Older age correlates with increased risk for prostate cancer, with the incidence peaking at age 65–74 years old. For prostatitis, the current data suggest that there is an increased risk for prostate cancer, but the studies are of low quality.
It is unclear how exercise affects a person’s risk, but some studies suggest a decrease in risk with exercise. Most experts believe BPH is not a risk factor for prostate cancer. However, the data is conflicting.