What Is a Normal PSA Level by Age? High Level and Chart

PSA levels between 4.0 and 10.0 ng/mL might suggest the possibility of prostate cancer (in about 25 percent of cases) or BPH.

Prostate-specific antigen (PSA) is a protein produced by the glandular tissue of the prostate (a walnut-sized gland just below the bladder and in front of the rectum in males). PSA levels can be detected in the blood, urine, or semen. Blood PSA testing is used as a screening test for prostate cancer.

Prostate-specific antigen (PSA) levels by age remain the same across most populations. A PSA level above 4.0 ng/mL in any age group must be investigated. However, PSA levels can spike in noncancerous conditions, such as benign prostate hypertrophy (BPH), urinary tract infections, prostatitis, consumption of testosterone supplements, recent catheterization, and injuries to the pelvic region.

Start screening for PSA to rule out prostatic cancer starting at the age of 55 years. However, you may require PSA screening between the ages of 40 and 54 years in the following situations:

• A first-degree relative (such as your father or brother) or extended family member who has had prostate cancer
• Individuals of African American ethnicity are at a higher risk of developing aggressive cancers

• PSA levels between 4.0 and 10.0 ng/mL might suggest the possibility of prostate cancer (in about 25 percent of cases) or BPH.
• PSA levels above 10.0 ng/mL should be urgently discussed with your doctor because these are associated with a 50 percent chance of having prostate cancer.
• PSA levels from 0.25 ng/mL to 4 ng/mL, along with symptoms of prostate enlargement (urinary retention, ejaculation problems, and inability to maintain urine flow), must be investigated further with sonography, a digital rectal examination, and patient history.

The table below shows normal PSA levels by age and when they may be a concern.

The U.S. Preventive Service Task Force as well as the American Urology Association recommends against routine screening PSA for men over 70.

PSA levels do not have a definitive upper limit and, in some cases, may rise to tens or even hundreds of thousands of nanograms per milliliter (ng/mL). However, in general, anything over 10 ng/mL is linked to a 50% chance of prostate cancer, and the doctors will order more tests. The ranges of elevation and their significance are summarized below:

The amount by which the prostate-specific antigen (PSA) levels rise in a year is called PSA velocity. Thus, if the initial PSA reading is about 10 ng/mL and it rises rapidly year on year, this can point to early-stage prostate cancer.

• Most research indicates that an increase of 0.75 ng/mL a year is an early indicator of prostate cancer if a man has a total PSA result between 4.0 and 10.0 ng/mL.
• An increase of 2.0 ng/mL over a year predicts a higher likelihood of death due to aggressive prostate cancer.
• PSA velocity may help predict survivability from prostate cancer.
• Men with a PSA increase of 0.35 ng/ML or less over a year have a 92 percent survival rate.
• Men with PSA levels of more than 0.35 ng/mL over a year have a 54 percent survival rate.

Early diagnosis and regular screening can aid in both the diagnosis and decision on treatment when it comes to prostate cancers.

1. Phi test: The Prostate Health Index (PHI or Phi) combines three blood tests for prostate-specific antigen (PSA), total PSA, free PSA, and pro-PSA. These are different fractions of PSA antigens found in the blood. Experts believe that these values give a more accurate Phi score and better determine the probability of finding cancer during a biopsy.
2. PCA3: This is a urine test that accurately detects the risk of prostate cancer by examining the expression of the PCA3 gene, a gene-specific to prostate cancer.
3. 4KScore: Another blood test measures total PSA, free PSA, intact PSA, and certain enzymes called kallikrein. A special computer-based algorithm used with the patient’s age and physical exam gives a probability of having aggressive prostate cancer.

However, none of these tests are conclusive on their own. When performed in addition to a PSA test, a digital rectal exam and biopsy can provide more information about a specific cancer.

• What is a good PSA level by age? PSA levels vary with age. Normal values are 0-2.5 ng/mL for men aged 40-50, 2.5-3.5 ng/mL for those aged 50-60, and 3.5-4.5 ng/mL for those aged 60-70.
• What is an alarming PSA number? An alarming PSA number is more than 10 ng/mL, as it may be linked to a 50% chance of prostate cancer.
• How can I lower my PSA quickly? There is no proven way to lower PSA levels quickly. However, certain lifestyle and dietary changes may help improve PSA levels over time. These include eating more lycopene-rich foods like tomatoes, watermelon, and grapefruit, following a plant-based diet, taking vitamin D supplements if recommended, and increasing physical activity.
• At what PSA level should I be concerned? A PSA level of 4 ng/mL or higher can be concerning, particularly if it is elevated for your age or rising rapidly. It may indicate a prostate condition such as benign prostatic hyperplasia (BPH), prostatitis, or possibly early-stage prostate cancer.