Prostate Health Blood Test
PSA Test Results Explained: Total PSA, Free PSA, and Percent Free PSA
Written and reviewed by Shervin Badkhshan, MD · Last reviewed
November 2026
QUICK ANSWER
PSA (prostate-specific antigen) is a blood test that measures a protein made by the prostate. A high PSA does not mean you have prostate cancer. Many common things, such as an enlarged prostate or inflammation, can raise PSA. Free PSA and percent free PSA can help sort out what a higher PSA means.
1. What the test is and why I ordered it
PSA (prostate-specific antigen) is a protein made by the prostate, measured with a blood test. I order it to screen for prostate cancer in men who choose screening, to recheck an earlier high result, or to monitor men after prostate treatment or on testosterone.
2. What the numbers usually mean
There is no single normal cutoff. Many labs flag values above 4.0 ng/mL, but what matters is your age, prostate size, and how the number changes over time.
- Age: PSA rises naturally with age and prostate growth. A value that is unremarkable at 70 may deserve a closer look at 45.
- Free PSA: a lower percent free PSA (under about 10%) raises the chance of cancer; a higher one (over about 25%) lowers it.
- PSA density (PSA divided by prostate volume from MRI or ultrasound): values above about 0.15 raise concern.
- Finasteride or dutasteride lower PSA by about half after 6 to 12 months. Doubling the number gives a fair comparison.
- Temporary rises can follow a urinary infection, prostate inflammation, ejaculation in the prior 1 to 2 days, long bike rides, or a catheter or cystoscopy.
3. What usually happens next
A single high PSA is not a diagnosis. Common next steps are repeating the test in 6 to 12 weeks (after treating any infection), a prostate MRI, and sometimes additional blood or urine markers. A biopsy is considered when the MRI or other tests point to it.
4. When to call right away
- Fever or chills with urinary symptoms
- You cannot urinate
- After a biopsy: fever, chills, heavy bleeding, or clots
5. Where to see your result and ask about it
Your actual result, and any note from your care team, is in your patient portal, the same one you use to book visits and send messages. Send questions about your result through the portal, or call the office at (516) 535-1900. If something feels urgent, call the office or go to the nearest emergency room. This page explains what results usually mean; it can't interpret yours.
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