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Is a PSA reading of 5.4 high?

A prostate specific antigen (PSA) reading of 5.4 is not high. Normal PSA is often quoted to be 4. But PSA levels vary from man to man. There is no such thing as an absolute normal, but there is a range of normal values. Your doctor will be considering the PSA reading in the context of your age and any previous PSA results.

As a man gets older, his prostate gland will usually begin to enlarge slightly. This is a perfectly normal part of ageing. PSA is a protein produced by prostate cells, so it is not surprising that the reading goes up as the prostate gets bigger. A PSA reading of between 4 and about 10 is usually related to an enlarged prostate, but not necessarily cancer. A reading of above 10 is an indication that a cancer might be present. But it can also be due to a benign (non cancerous) enlarged prostate.

PSA rises with age. So a PSA of 5.4 is more worrying in a man of 50 than it would be in a man of 80.

The PSA test on its own is not reliable enough to be used as a screening test to detect whether cancer is or is not present in a seemingly healthy man. This is why the test is not done routinely as part of a health check in the UK.

There is research going on into how reliable the PSA test can be. Research is also looking into combining it with other tests (such as a rectal ultrasound). Doctors want to see if the combination of tests would be reliable enough to detect cancer in the general population. If you have symptoms that you think may be related to prostate cancer, you can talk to your doctor. You may be offered a PSA test as part of an investigation of your symptoms.

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Updated: 12 March 2014