PSA free and total test

Total PSA includes PSA circulating freely and PSA attached to blood proteins. Free PSA refers to the unbound portion. Looking at both results can give a clinician additional context when a total PSA result needs clarification, but the relationship is not a diagnosis and should not be interpreted without the laboratory report.

Benign prostate enlargement, inflammation, infection, recent procedures, medicines, prostate size, and previous results may affect the assessment. A clinician may use the result with examination and other tests. The [PSA Test](/treatments/cancer-screening/psa-test/) page explains the broader test.

Ask whether the report gives both free and total PSA, the laboratory’s units, and any interpretation supplied by the laboratory. Share details of urinary infection, fever, catheter use, ejaculation, or recent prostate manipulation before a repeat test is planned.

If concern persists, the next step may be observation, repeat testing, examination, MRI, or biopsy. An [MRI Scan](/treatments/diagnostics-and-staging/mri-scan/) can provide structural information, but the choice depends on the whole clinical picture.

Follow up an unexpected free or total PSA result and report new urinary difficulty, blood in urine or semen, or continuing pelvic, back, or hip pain. Seek urgent care if urine will not pass or if urinary symptoms occur with fever or severe illness.

Ask what each result means in your laboratory’s system, whether the pair should be repeated, and how your symptoms and previous results affect interpretation. Ask what information MRI or biopsy would add before deciding on further testing.