What Is the Cut-off Level for PSA?
Traditionally, a level of 4.0 ng/ml has been considered a normal PSA screening test. However there is good evidence that many prostate cancers may be missed using this level for all men. Currently, there is controversy over what is the best PSA cut-off. If the level is set too low, unnecessary biopsies may be done, leading to the diagnosis and treatment for prostate cancer that may never have threatened a mans life. However, if the level is too high, serious cancers may be missed. Research Is Being Done to Improve PSA Screening Although these are still controversial, some of the more common methods to attempt to make screening with PSA more accurate include: • PSA velocity measures the rate of change of PSA over time, since a faster rise in PSA raises the possibility of a potentially serious prostate cancer. • Free PSA testing recognizes there are two forms of PSA circulating in the blood, both free (unattached to protein) or bound (attached to protein). With prostate cancer, there is
