What causes an elevated PSA level?

Prostate-specific antigen is a protein made by prostate cells. A small amount normally enters the blood, and the measured level can change when prostate tissue grows, becomes inflamed or is disturbed. Benign prostate enlargement becomes more likely with age and can increase PSA without cancer. Prostatitis and urinary infection may also produce a rise.

Ejaculation, vigorous cycling and recent procedures involving the prostate or urinary tract can temporarily affect the reading. Medicines used for prostate enlargement and some other treatments can alter how a result is interpreted. Prostate cancer can present with an elevated PSA, but the test cannot by itself distinguish cancer from a non-cancerous cause.

Review the result with the clinician who ordered the PSA test. Share any urinary symptoms, fever, recent ejaculation or cycling, procedures and all medicines or supplements. Depending on the context, the clinician may check urine, examine the prostate, repeat PSA after a suitable interval or compare the result with earlier measurements.

If further assessment is warranted, an MRI scan can help identify areas that merit closer evaluation. A biopsy may be recommended when the overall findings suggest that tissue needs examination. The decision draws on the PSA pattern, examination, imaging, general health and preferences rather than a single value in isolation.

Seek same-day medical advice for fever or chills with painful or difficult urination, because infection or acute prostate inflammation may require prompt treatment. Get urgent help if you cannot pass urine, develop severe lower abdominal pain, become confused or feel rapidly more unwell. Blood in the urine or semen and new persistent bone pain also warrant clinical assessment, although each can have several causes.

Ask whether anything around the test could have affected the result, how it compares with previous readings and whether it should be repeated. If more testing is proposed, ask what an MRI or biopsy could clarify, what preparation is needed and how the result would influence the next decision.