Prostate-specific antigen (PSA)
PSA has no agreed cut point. Sources use 4.0 ng/mL, 3.0, or limits that rise with age from 2.5 to 6.5. An invitation to screening cut prostate cancer deaths by 20% in a European trial and not significantly in a US trial. An estimated 20.7% to 50.4% of screen-detected cancers were overdiagnosed, and results vary from test to test.
- Status
- A blood test ordered by a clinician and also sold direct to consumers by some US laboratories. FDA classifies tumor-associated antigen test systems used to monitor patients with cancer as class II devices [1]. The US Preventive Services Task Force states that for men aged 55 to 69 the decision to be screened is an individual one, and it advises against PSA-based screening from age 70 [2].
- Measures
- The amount of prostate-specific antigen in blood, a protein made by normal and malignant cells of the prostate gland [2].
- Also called
- PSA, prostate specific antigen, prostate-specific antigen, total PSA, PSA total, tPSA, PSA blood test, serum PSA, PSA screening
- Tested for
- prostate cancer screening, enlarged prostate, urinary symptoms, monitoring after prostate cancer treatment, prostate health
Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on
Linked in research2
Reported risks2
- ModerateShown to give false positive results to 17.8% of men screened in the European trial, with 0.5% to 1.6% of men biopsied afterward admitted to hospital.Very common
- ModerateThe US Preventive Services Task Force states about 1 in 5 men have long-term urinary incontinence after radical prostatectomy and 2 in 3 long-term erectile dysfunction.Very common
Reference ranges
Each range is the one its source published, in ng/mL. Also reported in µg/L. Where sources differ, each is shown.
US National Library of Medicine, MedlinePlus
Men, as a general figure that the source says varies by age · [3]
| Range | What the source calls it |
|---|---|
| 4 or below ng/mL | "normal" |
| above 4 ng/mL | No name given |
MedlinePlus states that a normal level is considered to be up to 4.0 ng/mL, that this varies by age, and that for men in their 50s or younger the level is below 2.5 ng/mL in most cases. It states that the result cannot diagnose prostate cancer and that only a prostate biopsy can [3].
National Cancer Institute fact sheet, 2024
Men, as a general figure · [2]
| Range | What the source calls it |
|---|---|
| 4 or below ng/mL | No name given |
| above 4 ng/mL | "abnormal" |
The National Cancer Institute states that there is no single threshold that distinguishes a normal from an abnormal result, and that in general a level above 4.0 ng/mL is considered abnormal. It adds that some doctors apply a higher cutoff, such as 5 ng/mL, for older men and a lower one, such as 2.5 ng/mL, for younger men [2].
Oesterling and colleagues, 1993, age-specific reference range, men aged 40 to 49
Men aged 40 to 49 with no evidence of prostate cancer · [4], [5]
| Range | What the source calls it |
|---|---|
| 2.5 or below ng/mL | "reference range" |
| above 2.5 ng/mL | No name given |
Printed as 0.0 to 2.5 ng/mL, the 95th percentile, so the range has no lower band. From 471 men aged 40 to 79 in Olmsted County, Minnesota, who had no evidence of prostate cancer on PSA, rectal examination and ultrasound, measured with the Tandem-R assay. PSA rose with age and with prostate volume, by about 3.2% a year in a 60-year-old man [4]. The AUA/SUO guideline states that most studies identifying age-varying thresholds specify 2.5 ng/mL for men in their 40s, 3.5 in their 50s, 4.5 in their 60s and 6.5 in their 70s. It describes the commonly cited single threshold of 4 ng/mL as based on very early studies, and as too high for men in their 40s and 50s and too low for men in their 70s and 80s [5].
Oesterling and colleagues, 1993, age-specific reference range, men aged 50 to 59
Men aged 50 to 59 with no evidence of prostate cancer · [4], [5]
| Range | What the source calls it |
|---|---|
| 3.5 or below ng/mL | "reference range" |
| above 3.5 ng/mL | No name given |
Printed as 0.0 to 3.5 ng/mL, the 95th percentile. See the block for ages 40 to 49 for how the study was done and how the AUA/SUO guideline describes these thresholds [4][5].
Oesterling and colleagues, 1993, age-specific reference range, men aged 60 to 69
Men aged 60 to 69 with no evidence of prostate cancer · [4], [5]
| Range | What the source calls it |
|---|---|
| 4.5 or below ng/mL | "reference range" |
| above 4.5 ng/mL | No name given |
Printed as 0.0 to 4.5 ng/mL, the 95th percentile. See the block for ages 40 to 49 for how the study was done and how the AUA/SUO guideline describes these thresholds [4][5].
Oesterling and colleagues, 1993, age-specific reference range, men aged 70 to 79
Men aged 70 to 79 with no evidence of prostate cancer · [4], [5]
| Range | What the source calls it |
|---|---|
| 6.5 or below ng/mL | "reference range" |
| above 6.5 ng/mL | No name given |
Printed as 0.0 to 6.5 ng/mL, the 95th percentile. See the block for ages 40 to 49 for how the study was done and how the AUA/SUO guideline describes these thresholds [4][5].
Morgan and colleagues, 1996, age-specific reference range for Black men in their 40s
Black men in their 40s · [6]
| Range | What the source calls it |
|---|---|
| 2 or below ng/mL | "normal reference range" |
| above 2 ng/mL | No name given |
Printed as 0 to 2.0 ng/mL. The limit was set so that the test would detect 95% of prostate cancers in Black men, not as a percentile of men without cancer. At this limit the specificity was 93%. From 1,673 Black men with no clinical evidence of prostate cancer and 411 Black men with prostate cancer, seen from 1991 to 1995. The authors report that the earlier age-specific ranges, which hold specificity at 95%, would miss 41% of prostate cancers in Black men [6].
Morgan and colleagues, 1996, age-specific reference range for Black men in their 50s
Black men in their 50s · [6]
| Range | What the source calls it |
|---|---|
| 4 or below ng/mL | "normal reference range" |
| above 4 ng/mL | No name given |
Printed as 0 to 4.0 ng/mL, set for 95% sensitivity, at which the specificity was 88%. See the block for men in their 40s for how the study was done [6].
Morgan and colleagues, 1996, age-specific reference range for Black men in their 60s
Black men in their 60s · [6]
| Range | What the source calls it |
|---|---|
| 4.5 or below ng/mL | "normal reference range" |
| above 4.5 ng/mL | No name given |
Printed as 0 to 4.5 ng/mL, set for 95% sensitivity, at which the specificity was 81%. See the block for men in their 40s for how the study was done [6].
Morgan and colleagues, 1996, age-specific reference range for Black men in their 70s
Black men in their 70s · [6]
| Range | What the source calls it |
|---|---|
| 5.5 or below ng/mL | "normal reference range" |
| above 5.5 ng/mL | No name given |
Printed as 0 to 5.5 ng/mL, set for 95% sensitivity, at which the specificity was 78%. See the block for men in their 40s for how the study was done [6].
European Association of Urology guideline, 2026, threshold most often applied in screening
Men without symptoms, in a screening setting · [7], [5], [8]
| Range | What the source calls it |
|---|---|
| below 3 ng/mL | No name given |
| 3 or above ng/mL | "positive test" |
The guideline states that there are no agreed standards for defining abnormal PSA thresholds and that PSA is a continuous parameter, with higher levels indicating greater likelihood of prostate cancer. It reports that 3.0 ng/mL or above is the threshold most often applied in screening, at which 16.5% of invited men had a positive test. For men without symptoms and a level between 3 and 10 ng/mL it advises a repeat test before further investigation [7]. The AUA/SUO guideline traces the 3 ng/mL threshold to the European screening trial, and its screening statements set no single threshold [5]. The UK screening trial sent men for further tests at 3.0 ng/mL or higher [8].
European Association of Urology guideline, 2026, initial PSA at age 40
Men at 40 years of age, as an initial PSA level · [7]
| Range | What the source calls it |
|---|---|
| 1 or below ng/mL | "not at risk" |
| above 1 ng/mL | "at risk" |
From a recommendation rated weak. It sets follow-up intervals of two years for men it calls initially at risk, those with a level above 1 ng/mL at age 40, and allows follow-up to be postponed for up to eight years in those not at risk. The guideline's text describes men with a baseline below 1 ng/mL at 40 as at decreased risk of metastasis or death from prostate cancer several decades later. A result of exactly 1 is not placed by either wording, and is shown here with the lower band [7].
European Association of Urology guideline, 2026, initial PSA at age 60
Men at 60 years of age, as an initial PSA level · [7]
| Range | What the source calls it |
|---|---|
| 2 or below ng/mL | "not at risk" |
| above 2 ng/mL | "at risk" |
From the same weak-rated recommendation: follow-up every two years for men with a level above 2 ng/mL at age 60, and up to eight years for those not at risk. A result of exactly 2 is not placed by the guideline's wording, and is shown here with the lower band [7].
What has been shown to move it
Shown to lower it1
High-grade prostate cancer and PSA
One trial found high-grade prostate tumors in 6.4% on 5 mg against 5.1% on placebo. The label warns of this risk and of lowered PSA.
The Propecia label carries a warning on an increased risk of high-grade prostate cancer with 5-alpha reductase inhibitors and on the drug lowering PSA.
The numbers and sources
- How common
- Common: between 1 in 100 and 1 in 10 people.
- Effect
- High-grade tumors (Gleason 7 to 10) were found in 6.4% of men on finasteride 5 mg against 5.1% on placebo over 7 years [7]. The Propecia label carries a warning on an increased risk of high-grade prostate cancer with 5-alpha reductase inhibitors and on the drug lowering PSA [10].
- Population
- 18,882 men aged 55 or older [7].
- Sources
- [7], [10]
- Caveats
- One trial, at 5 times the hair loss dose, in older men.
- Why limited
- This rests on one trial, of 18,882 people. Strength counts independent studies that agree, so one trial is limited at any size.
Tested, and not shown to change it1
Small drops in blood counts and albumin
Small drops in hematocrit, hemoglobin, white cells and albumin were seen on terazosin in trials, which the label attributes to blood dilution. PSA did not change.
Treatment for up to 24 months had no significant effect on PSA.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- Small but statistically significant decreases in hematocrit, hemoglobin, white blood cells, total protein and albumin were seen in controlled trials. Treatment for up to 24 months had no significant effect on PSA [19].
- Population
- People in terazosin controlled trials [19].
- Sources
- [19]
- Caveats
- The label gives no size for the drops.
How it compares with the reference method
Mixed results2
Percent free PSA, a different quantity
One study found a free PSA cutoff of 25% detected 95% of cancers and avoided 20% of unnecessary biopsies in men with a total PSA of 4.0 to 10.0 ng/mL.
The numbers and sources
- Compared with
- Prostate biopsy
- Effect
- Free PSA is the share of PSA in blood that is not bound to other proteins, reported as a percentage of total PSA [3]. In men aged 50 to 75 with a total PSA of 4.0 to 10.0 ng/mL and a prostate that felt benign, a cutoff of 25% free PSA or less detected 95% of cancers while avoiding 20% of unnecessary biopsies. The risk of cancer ran from 8% to 56% across the range of percent free PSA, higher at lower percentages [24]. The AUA/SUO guideline states that a lower percent free PSA is associated with a greater likelihood of finding prostate cancer on biopsy [5].
- Population
- 773 men, 379 with prostate cancer and 394 with benign prostatic disease, at seven US medical centers [24].
- Sources
- [24], [5], [3]
- Caveats
- Percent free PSA is a different quantity from total PSA, so the ranges on this page do not apply to it. The study covered only men with a total PSA of 4.0 to 10.0 ng/mL [24].
PSA density, a different quantity
Mixed results: proposed PSA density cutoffs run from 0.07 to 0.15 ng/mL per cc, with lower cutoffs finding more cancers and higher ones raising fewer false alarms.
The numbers and sources
- Compared with
- Prostate biopsy
- Effect
- PSA density is serum PSA divided by the volume of the prostate measured on imaging [5][7]. The AUA/SUO guideline states that numerous studies tie a higher density to the risk of clinically significant cancer on biopsy, that lower thresholds such as 0.07 have higher sensitivity and lower specificity than higher thresholds such as 0.15, and it cautions against using a threshold in isolation [5]. The European guideline reports that several studies found a density over 0.1 to 0.15 ng/mL/cc predictive of prostate cancer, and that men below 0.09 were unlikely (4%) to be diagnosed with clinically significant cancer [7]. In men without cancer, PSA rose with prostate volume (r = 0.55) [4].
- Population
- Studies summarized in two guidelines [5][7]. 471 men aged 40 to 79 [4].
- Sources
- [5], [7], [4]
- Caveats
- PSA density is a different quantity from total PSA and needs a measurement of prostate volume, so the ranges on this page do not apply to it.
Did not match the reference method3
No single cut point against biopsy
Not shown to separate men with and without prostate cancer at any one cut point: a 4.1 ng/mL cutoff found 20.5% of cancers with 93.8% specificity.
The numbers and sources
- Compared with
- Prostate biopsy
- Effect
- In the placebo group of a US prevention trial, cutoffs of 1.1, 2.1, 3.1 and 4.1 ng/mL detected 83.4%, 52.6%, 32.2% and 20.5% of prostate cancers, with specificities of 38.9%, 72.5%, 86.7% and 93.8%. The area under the curve was 0.678 for any cancer and 0.782 for Gleason grade 7 or higher [19]. Among men in the same trial whose PSA never exceeded 4.0 ng/mL and who had a biopsy after seven years, 15.2% had prostate cancer: 6.6% at 0.5 ng/mL or below, 10.1% at 0.6 to 1.0, 17.0% at 1.1 to 2.0, 23.9% at 2.1 to 3.0 and 26.9% at 3.1 to 4.0. Of those cancers, 14.9% had a Gleason score of 7 or higher [20].
- Population
- 8,575 men aged 55 or older, 5,587 of whom had at least one biopsy [19]. 2,950 men aged 62 to 91 [20].
- Sources
- [19], [20]
- Caveats
- Both analyses come from one trial, whose men entered with a PSA of 3.0 ng/mL or lower. The authors describe a continuum of risk at all values of PSA [19].
One test to the next
Shown to vary from test to test: 44% of men with a result above 4 ng/mL had a result at or below it at a later yearly visit.
The numbers and sources
- Compared with
- The same man's later results
- Effect
- In men tested five times over 4 years, 68 of 154 (44%) with a PSA above 4 ng/mL had a normal result at one or more later visits, as did 116 of 291 (40%) with a PSA above 2.5 [21]. The AUA/SUO guideline states that a newly raised PSA returns to a normal level in 25% to 40% of men on retesting, and cites a study in which 283 of 1,686 men (17%) with a PSA of 3 to 10 ng/mL had a result below 3 eight weeks later [5]. The European guideline reports that one-third of men with a PSA below 10 ng/mL differed by more than 1.0 ng/mL at a second measurement [7].
- Population
- 972 men with a median age of 62 in a trial unrelated to the prostate [21].
- Sources
- [21], [5], [7]
- Caveats
- The AUA/SUO guideline lists urinary tract infection and recent instrumentation of the urinary tract among causes of a temporary rise [5].
Assay calibration
Small studies found one assay read about 20% lower with WHO calibration than with the older Hybritech calibration, and four WHO-calibrated assays still differed by up to 23%.
The numbers and sources
- Compared with
- The same samples measured with another calibration or another assay
- Effect
- In 106 samples, total PSA was 20.3% lower with the World Health Organization calibration than with the Hybritech calibration of the same assay. Applied to 5,865 men, that meant 19% to 20% fewer biopsies and 19% to 20% fewer cancers detected at cutoffs of 3.0 or 4.0 [22]. In 50 patients measured with four assays that were all WHO-calibrated, median total PSA ran 3% to 23% higher on three of them than on the fourth, and free PSA differed by 22% to 49% [23].
- Population
- 106 serum samples and a cohort of 5,865 men [22]. 50 patients at four study sites [23].
- Sources
- [22], [23]
- Caveats
- The cancer detection figures come from a simulation, not from men retested with both calibrations [22]. A cut point set with one assay or calibration may not carry over to another.
What studies tie it to
Linked in research2
Overdiagnosis in trials of screening
Shown in screening trials to find cancers that would not have caused harm, estimated at 20.7% to 50.4% of the cancers screening detected.
The numbers and sources
- Effect
- The evidence review for the US Preventive Services Task Force estimated that overdiagnosis occurred in 20.7% to 50.4% of screen-detected cancers [15]. The National Cancer Institute defines overdiagnosis as detecting tumors that would not have caused problems during a person's lifetime [2]. In the European trial at 9 years, 1,410 men had to be screened and 48 additional cancers treated to prevent one prostate cancer death, and its authors reported a high risk of overdiagnosis. At 16 years, 18 men had to be diagnosed per death prevented [16][9]. Screening raised the detection of low-grade cancer: Gleason score 6 or lower in 2.2% of invited men against 1.6% of controls in the UK trial, and a rate ratio of 1.17 (95% CI 1.11 to 1.23) for Gleason 2 to 6 disease in the US trial [8][11].
- Population
- 63 studies with 1,904,950 participants in the evidence review [15]. 162,243 men in the core age group of the European trial [16]. 415,357 UK men [8]. 76,683 US men [11].
- Sources
- [15], [2], [16], [9], [8], [11], [5]
- Caveats
- Overdiagnosis cannot be observed in one man and is estimated from groups. The AUA/SUO guideline states that estimates depend on the population, design and method, that estimates based on excess incidence in trials generally overstate the long-term risk, and that the risk rises with age [5].
Death from prostate cancer decades later, by PSA in midlife
Linked to later death from prostate cancer: 90% of deaths by age 85 were in men whose PSA at 60 was above 2 ng/mL.
The numbers and sources
- Effect
- In Swedish men who gave blood at age 60 and were followed to 85, PSA predicted death from prostate cancer with an area under the curve of 0.90 (95% CI 0.84 to 0.96). Men in the top quarter, above 2 ng/mL, accounted for 90% of the deaths (78% to 100%), though only a minority of them died of the disease. Men at the median or lower, 1 ng/mL or below, had a 0.5% risk of metastasis and a 0.2% risk of death from prostate cancer by 85 [17]. In men who gave blood at 45 to 49, the top tenth of PSA (1.6 µg/L or above) accounted for 44% of later prostate cancer deaths (34% to 53%). Below the median of 0.68 µg/L, the 15-year risk of metastasis was 0.09% [18]. The AUA/SUO guideline cites a US cohort in which 82%, 71% and 86% of lethal cases arose in men above the median at ages 40 to 49, 50 to 54 and 55 to 59 (medians 0.68, 0.88 and 0.96 ng/mL) [5].
- Population
- 1,167 men aged 60 who gave blood in 1981 [17]. 21,277 men aged 27 to 52 who gave blood from 1974 to 1984, with a median follow-up of 27 years [18].
- Sources
- [17], [18], [5]
- Caveats
- Observational, from one Swedish city where PSA testing was rare during follow-up, plus a US cohort described in a guideline. The cut points are medians and upper fractions of a distribution, not reference limits.
Mixed results1
Death from prostate cancer in trials of screening
Mixed results: an invitation to screening cut prostate cancer deaths by 20% in the European trial and 8% in a UK trial, with no significant change in the US trial.
The numbers and sources
- Effect
- In the European trial, the rate ratio for death from prostate cancer at 16 years was 0.80 (95% CI 0.72 to 0.89), an absolute difference of 0.18%. To prevent one death, 570 men had to be invited and 18 diagnosed [9]. In the US trial the rate ratio was 1.04 (0.87 to 1.24) at a median of 15 years and 0.93 (0.81 to 1.08) at about 17 years [10][11]. In the UK trial of a single invitation, it was 0.96 (0.85 to 1.08) at 10 years and 0.92 (0.85 to 0.99) at 15 years, when 0.69% of invited men and 0.78% of control men had died of prostate cancer [12][8]. A meta-analysis of five trials found screening probably has no effect on death from any cause (incidence rate ratio 0.99, 0.98 to 1.01) and may have no effect on prostate cancer death (0.96, 0.85 to 1.08), or a small effect in the trial at lower risk of bias (0.79, 0.69 to 0.91), about one fewer prostate cancer death per 1,000 men screened over 10 years [13]. The US Preventive Services Task Force estimates that screening men aged 55 to 69 may prevent about 1.3 prostate cancer deaths per 1,000 men over about 13 years [14].
- Population
- 162,389 men aged 55 to 69 in eight European countries [9]. 76,683 US men aged 55 to 74 [10][11]. 415,357 UK men aged 50 to 69 at 573 primary care practices [12][8]. Five trials with 721,718 men [13].
- Sources
- [9], [10], [11], [12], [8], [13], [15], [14], [5]
- Caveats
- The trials tested an invitation to screening followed by biopsy and treatment, not a PSA level. They differed in ways that bear on the results. In the US trial an estimated 86% of control men had some PSA testing, its biopsy cut-off was 4 ng/mL against 3 in the European trial, and 34% of men with a raised result were biopsied against over 90% [10][5]. In the UK trial 36% of invited men had the single test [12]. Deaths from any cause did not differ in the US trial, the UK trial or the pooled analysis [10][8][13].
Risks
Reported risks2
False positive results and complications of biopsy
Shown to give false positive results to 17.8% of men screened in the European trial, with 0.5% to 1.6% of men biopsied afterward admitted to hospital.
The numbers and sources
- How common
- Very common: more than 1 in 10 people.
- Effect
- Of 61,604 men screened in the European trial, 17.8% received a false positive result. In three cohorts, complications needing hospital admission occurred in 0.5% to 1.6% of men who had a biopsy after an abnormal screening result [15]. The National Cancer Institute reports that about 6% to 7% of men have a false positive result on any one screening round, and that about 25% of men biopsied for a raised PSA are found to have prostate cancer [2]. A meta-analysis estimated by modeling that for every 1,000 men screened, about 1 more would be admitted to hospital for sepsis, 3 more would need pads for urinary incontinence and 25 more would report erectile dysfunction [13].
- Population
- 61,604 screened men in the European trial, and three cohorts with 15,136 men who had a biopsy [15].
- Sources
- [15], [2], [13]
- Caveats
- The frequency band is for a false positive result among men screened in the European trial. Hospital admission after biopsy was uncommon to common, at 0.5% to 1.6%. The meta-analysis notes that direct trial data on biopsy and treatment complications were limited, so its figures are modeled [13].
Harms of treating a cancer found by screening
The US Preventive Services Task Force states about 1 in 5 men have long-term urinary incontinence after radical prostatectomy and 2 in 3 long-term erectile dysfunction.
The numbers and sources
- How common
- Very common: more than 1 in 10 people.
- Effect
- The task force lists erectile dysfunction, urinary incontinence and bowel symptoms as harms of prostate cancer treatment. It states that about 1 in 5 men who have a radical prostatectomy develop long-term urinary incontinence and 2 in 3 experience long-term erectile dysfunction [14]. In a trial of men with screen-detected cancer, neither surgery nor radiation was associated with significantly lower prostate cancer mortality than active monitoring, though each lowered the risk of metastatic disease [15].
- Population
- Men treated for prostate cancer in the studies the task force reviewed [14]. 1,643 men with screen-detected prostate cancer [15].
- Sources
- [14], [15]
- Caveats
- These are harms of treatment, which follow a test result only when a cancer is found and treated. The frequency band applies to men who have a radical prostatectomy, not to all men tested.
Sources
- US Food and Drug Administration. 21 CFR 866.6010, Tumor-associated antigen immunological test system. Electronic Code of Federal Regulations. https://www.ecfr.gov/current/title-21/section-866.6010
- National Cancer Institute. Prostate-Specific Antigen (PSA) Test. Fact sheet dated December 12, 2024. https://www.cancer.gov/types/prostate/psa-fact-sheet
- US National Library of Medicine. Prostate-specific antigen (PSA) blood test. MedlinePlus Medical Encyclopedia. Reviewed February 3, 2025. https://medlineplus.gov/ency/article/003346.htm
- Oesterling JE, Jacobsen SJ, Chute CG, et al. Serum Prostate-Specific Antigen in a Community-Based Population of Healthy Men. Establishment of Age-Specific Reference Ranges. JAMA. 1993. https://doi.org/10.1001/jama.1993.03510070082041
- Wei JT, Barocas D, Carlsson S, et al. Early Detection of Prostate Cancer: AUA/SUO Guideline (2023, amended 2026). American Urological Association and Society of Urologic Oncology. 2026. https://www.auanet.org/documents/Guidelines/PDF/2026%20Guidelines/EDPC%202026%20Unabridged%20FINAL.pdf
- Morgan TO, Jacobsen SJ, McCarthy WF, et al. Age-Specific Reference Ranges for Serum Prostate-Specific Antigen in Black Men. New England Journal of Medicine. 1996. https://doi.org/10.1056/nejm199608013350502
- European Association of Urology. EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer, chapter 5, Diagnostic Evaluation. 2026 edition. https://uroweb.org/guidelines/prostate-cancer/chapter/diagnostic-evaluation
- Martin RM, Turner EL, Young GJ, et al. Prostate-Specific Antigen Screening and 15-Year Prostate Cancer Mortality: A Secondary Analysis of the CAP Randomized Clinical Trial. JAMA. 2024. https://doi.org/10.1001/jama.2024.4011
- Hugosson J, Roobol MJ, Månsson M, et al. A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer. European Urology. 2019. https://doi.org/10.1016/j.eururo.2019.02.009
- Pinsky PF, Prorok PC, Yu K, et al. Extended mortality results for prostate cancer screening in the PLCO trial with median follow-up of 15 years. Cancer. 2017. https://doi.org/10.1002/cncr.30474
- Pinsky PF, Miller E, Prorok P, et al. Extended follow-up for prostate cancer incidence and mortality among participants in the Prostate, Lung, Colorectal and Ovarian randomized cancer screening trial. BJU International. 2019. https://doi.org/10.1111/bju.14580
- Martin RM, Donovan JL, Turner EL, et al. Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial. JAMA. 2018. https://doi.org/10.1001/jama.2018.0154
- Ilic D, Djulbegovic M, Jung JH, et al. Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ. 2018. https://doi.org/10.1136/bmj.k3519
- US Preventive Services Task Force, Grossman DC, Curry SJ, et al. Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018. https://doi.org/10.1001/jama.2018.3710
- Fenton JJ, Weyrich MS, Durbin S, et al. Prostate-Specific Antigen-Based Screening for Prostate Cancer: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2018. https://doi.org/10.1001/jama.2018.3712
- Schröder FH, Hugosson J, Roobol MJ, et al. Screening and Prostate-Cancer Mortality in a Randomized European Study. New England Journal of Medicine. 2009. https://doi.org/10.1056/nejmoa0810084
- Vickers AJ, Cronin AM, Björk T, et al. Prostate specific antigen concentration at age 60 and death or metastasis from prostate cancer: case-control study. BMJ. 2010. https://doi.org/10.1136/bmj.c4521
- Vickers AJ, Ulmert D, Sjoberg DD, et al. Strategy for detection of prostate cancer based on relation between prostate specific antigen at age 40-55 and long term risk of metastasis: case-control study. BMJ. 2013. https://doi.org/10.1136/bmj.f2023
- Thompson IM, Ankerst DP, Chi C, et al. Operating Characteristics of Prostate-Specific Antigen in Men With an Initial PSA Level of 3.0 ng/mL or Lower. JAMA. 2005. https://doi.org/10.1001/jama.294.1.66
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