Prostate specific antigen (PSA) - serum

Last updated: Friday, 04, June, 2010

The item number and fee shown are for Australia only. The fee is the Medicare Schedule Fee. Laboratories may charge above this fee in some circumstances.

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Item Process
Specimen

5 mL blood in plain tube.

Method

Immunoassay.

Reference Interval

Depends on method and varies with age - consult pathologist.

Application

Diagnosis and monitoring of prostatic carcinoma.

PSA has generally replaced acid phosphatase as it has greater sensitivity (especially for early invasive carcinoma) and specificity. The test is not recommended as a stand-alone screening test for carcinoma of the prostate.

Interpretation

The result should always be interpreted in conjunction with the findings on digital rectal examination and other clinical findings.

Marked elevation is indicative of carcinoma, but normal or slightly elevated PSA levels do not exclude it. 
The most common non-malignant cause of increased PSA is benign prostatic hypertrophy. However, levels are also increased in prostatitis, prostatic ischaemia and/or infarction and acute renal failure.
Assays for total PSA should measure the free and complexed forms equally.
Specific assays are also available for each form.
The complexed form is probably more specific for prostatic cancer but the diagnostic role of complexed PSA assays is not yet established. 
Results that do not correspond to the clinical findings should be repeated on a fresh sample. 
PSA is most useful in monitoring the course of prostatic carcinoma.

Reference

Nash AF and Meleginek I. Endocr Relat Cancer 2000; 7: 37-51.