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Causes of Elevated PSA

Causes of Elevated PSA

Causes of a high PSA level can be anything as simple as a long bicycle ride, or a grievous one, like prostate cancer. Here is a brief overview about the common causes of elevated PSA levels.
Sonia Nair
Most of us relate PSA blood test to prostate cancer, as it is used as a screening test for detecting malignancy of the prostate. This test is meant for checking the level of prostate specific antigen (PSA) in the blood. PSA is a protein produced by the prostate gland. Even though, its effectiveness 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.
PSA Blood Test Results
The normal PSA level in a healthy person is said to be below 4 ng/mL. A PSA level of ≥ 4 ng/mL, may indicate 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. However, PSA test cannot be a conclusive proof for having or not having cancer, as men with any PSA level have a risk of cancer. The only difference is that, those with elevated PSA levels have a higher risk. Factors like, age of the person and the rate of increase in the PSA level during the last few years, must be taken into consideration, while interpreting the PSA test results. Another point to be noted is the ratio of free PSA to total PSA (the lower the level the greater the risk of cancer). Apart from cancer, a higher PSA level may be an indication of other prostate conditions.
What Causes an Elevated PSA Level
So high PSA levels may indicate problems other than prostate cancer. Even a temporary elevation of PSA level can be seen in certain cases. The following are some of the common causes of increased levels of PSA.
  • As we all know, prostate cancer could be a cause for an elevated PSA level. This cancer may not have any early symptoms. During the later stages, the affected person may experience erectile problems, pain in the pelvic area and back, and variations in urinary flow and frequency.
  • A common cause of elevated PSA in men, especially older men, is the condition called enlarged prostate (medically termed 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. It causes difficulty in urination and changes in urine flow.
  • Even prostatitis or inflamed prostate gland (either caused by infection or other factors) is one among the causes of elevated PSA. In this case too, the symptoms may be more concentrated on the urinary flow and frequency. Painful urination, lower back pain, burning sensation during urination, and pain in the pelvic area, hip, penis and scrotum, are observed.
  • There are various other conditions that can cause a temporary rise in PSA levels. It has been observed that digital rectal examination (DRE) can cause an increase in the PSA level. Even prostate biopsy may cause this condition. 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 rides may also lead to increased PSA levels. It has also been noted that a test done within 24 hours of ejaculation may show a rise in 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 underlying condition, that has to be confirmed with screening tests like, biopsy, digital rectal exam, trans rectal ultrasound, and blood tests for detecting infection.
Disclaimer: This article is for informational purposes only, and should not be used as a replacement for expert medical advice. Visiting your physician is the safest way to diagnose and treat any health condition.