What causes elevated PSA levels?

Elevated PSA levels can be caused by benign prostate enlargement, inflammation, infection, recent prostate activity, or prostate cancer. PSA is a protein made by prostate cells, and a raised result is a signal for interpretation rather than a diagnosis.

Benign prostate enlargement becomes more common with age and can raise PSA while causing urinary symptoms. Prostatitis or a urinary infection may temporarily increase PSA and may cause burning, pelvic discomfort, fever, or difficulty passing urine. Ejaculation, vigorous cycling, catheter use, or a recent prostate examination can affect a result in some circumstances. Prostate cancer is another possible cause, but PSA can be normal in some people with cancer and raised without cancer. The result is considered alongside age, symptoms, prostate size, previous results, medicines, and family history.

Ask the clinician who ordered the test how to prepare for any repeat PSA and whether infection or recent procedures could have influenced it. The next step may be a repeat blood test, urine assessment, or examination. If concern remains, an MRI scan can help assess the prostate, and a biopsy may be recommended when tissue sampling is needed. Do not take antibiotics or stop prostate medicines solely to change a PSA result unless prescribed.

Contact a clinician promptly for a raised PSA result so its context and follow-up are clear. Seek urgent care if you cannot pass urine, have fever with pelvic or urinary pain, see significant blood in the urine, or feel acutely unwell. New bone pain, unexplained weight loss, or worsening urinary symptoms also warrant timely review, although they can have causes other than prostate cancer.

Could infection, enlargement, medicines, or recent activity have affected my result? Should the PSA be repeated? How does this result compare with earlier tests? Would an MRI scan or biopsy be appropriate? What urinary symptoms require urgent help?