MEN: Do You Know What May Falsely Elevate your PSA Test?

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Is PSA worth testing?

There is a current controversy about whether it should be used as a diagnostic tool for detecting prostate cancer. Because a rising PSA usually leads to more invasive testing, which is more often negative for cancer, some authorities are questioning the wisdom of regular testing. However, PSA testing, especially when conducted and interpreted properly, can enable very early detection of prostate cancer in men. It should not be considered a “diagnostic test” for prostate cancer. Instead it’s a “screening test to identify potential risk” for prostate cancer.

I am a huge fan of this type of simple, inexpensive screening that can give us a snapshot of possible risk of disease. These tests should be conducted and interpreted skillfully and appropriately. Unfortunately, most men are not notified of a few activities that can FALSELY elevate their PSA test result. And this can lead to more unnecessary expense, stress and exposure to invasive testing.

What activities can lead to false elevations?

  • Any ejaculation within 48 hours of testing.
  • Any manipulation of the prostate gland such as bike riding. Or, a digital medical exam of the prostate gland conducted in your doctor’s office. Manipulation of the prostate also should not occur within 48 hours before a PSA blood test. Unfortunately, often men first have the exam in the doctor’s office and then are sent directly for a blood test, which can lead to a false higher reading.
  • Time of day variability. PSA levels have a rhythm in the body. You should always test at the same time- either morning or afternoon. All of your PSA screening tests should be at that same chosen time.
  • Lab variability. Be sure to use the same lab for all tests.

Although there is some controversy as to how much each of these will effect your blood test result, there is no harm in being extra diligent to insure a more accurate test.

What if the PSA test is still elevated?

Again, it’s a screening test and not diagnostic. It often requires just following it more closely. A PSA test that is rising quickly or is above 4 ng/mL, signals further observation or testing. Incorporating a more recent test called PSA-3 could further shed light of the result. The PSA-3 test is actually a urine test that is conducted directly after a very specific digital prostate manipulation test. It detects genetic material excreted into the urine. Since prostate cancer cells produce much more of this than normal cells, it can provide additional information for better interpretation of the PSA test result.

Make sure to get your regular PSA testing – it is a valuable screening test when conducted and interpreted skillfully. It has provided thousands of men early detection of prostate cancer when less invasive and more treatment choices are available.