Prostate cancer is one of the most common cancers affecting men today, and yet many men remain unaware of one of the most effective tools available for early detection: the PSA test.
Short for prostate-specific antigen, this simple blood test measures levels of a protein produced by the prostate gland. Elevated levels can signal the presence of prostate cancer, even before symptoms begin to appear.
If you're a man over the age of 40, especially with a family history of prostate cancer or related conditions, getting an annual PSA test may be one of the most important steps you can take for your health.
At Greater Boston Urology, we believe that knowledge is power—especially when it comes to protecting your long-term health. In this blog, Dr. Keith Bleiler guides you through what the PSA test is, how it works, and when to get it, helping you feel confident in taking control of your health.
The information from this blog was featured in Dr. Bleiler’s video, “What’s a PSA Test & When Should You Get One?” As always, this content is intended to be educational and should not be considered medical advice. Please consult with your doctor regarding your unique situation.
What Does a PSA Test Screen For?
PSA, or prostate-specific antigen, is a protein made by both normal and cancerous prostate cells. A small amount naturally enters the bloodstream, and measuring these levels through a basic blood test can help identify changes that may suggest an issue that needs further exploration.
PSA testing has been used since the 1980s and remains one of the most valuable screening tools for prostate cancer detection. In fact, nearly every diagnosis of prostate cancer begins with a PSA test.
“It's the hallmark blood test used in diagnosing virtually every single case of prostate cancer,” said Dr. Bleiler.
While elevated PSA levels don’t automatically mean cancer (other conditions like benign prostatic hyperplasia [BPH] or prostatitis can also raise PSA), it’s often the first signal that further evaluation is needed.
Why Should You Get Your PSA Tested Every Year?
Routine PSA testing allows your doctors the chance to detect potential issues before symptoms arise. Prostate cancer often grows slowly and silently, meaning you could have it without feeling any different. By measuring PSA annually, your doctor can monitor changes over time rather than reacting to a single elevated result.
Studies have shown that PSA screening has contributed to a decline in prostate cancer deaths over the past few decades. Early-stage prostate cancer is typically more treatable and may even be eligible for active surveillance—a strategy that involves close monitoring instead of immediate surgery or radiation.
Who Should Consider Regular PSA Testing?
While the answer is different for everyone based on their own circumstance, the American Urological Association recommends that men begin discussing PSA screening with their doctors between the ages of 40 and 50. Those at higher risk—such as Black men or men with a direct relative diagnosed with prostate cancer at a young age—should consider beginning that conversation at 40 (or even sooner).
What if More Testing is Needed?
Some patients are understandably hesitant about PSA screening due to concerns about false positives or the potential for unnecessary procedures. It’s true that PSA levels can fluctuate for reasons unrelated to cancer. That’s why it's important to interpret PSA results in the broader context of your medical history, family risk, and physical exams.
“Just because you have an elevated PSA test doesn't mean you have prostate cancer,” Dr. Bleiler said. “In fact, the vast majority of men with an elevated PSA test do not have prostate cancer. The PSA test can be elevated because the prostate is enlarged, or there's some sort of inflammatory process going on with the bladder or the prostate, or this can just be the way the test is and natural for a guy to have in total absence of prostate cancer.”
At Greater Boston Urology, we focus on shared decision-making. That means your provider will help you understand what your results mean, whether additional steps are necessary, and what options are available to you.
“Depending on the results, you and I will talk about whether more testing is necessary, such as a biopsy, an MRI or additional molecular tests, or do we just simply repeat the PSA test,” according to Dr. Bleiler.
Moving from Awareness to Action
Annual PSA testing offers a safe and quick way to take control of your health. If you're a man over 40, consider discussing a PSA test with your doctor.
“I've been doing this for over 30 years, and in my opinion, any man over the age of 40 should have at least one PSA test and every man over the age of 50 to get this blood test done every single year with a routine prostate exam,” Dr. Bleiler said.
If it’s been more than a year since your last PSA test, you want to learn more about past results, or you have more questions, schedule an appointment at one of our convenient locations today.
For more information, check out Dr. Bleiler’s video below: