What men should know about their PSA levels

  • What is a file PSA value?
  • How dangerous Prostate cancer?
  • Why is the PSA value often in a file criticism?

Prostate cancer is she The most common type of cancer in men. to me Early detection Men over the age of 45 can benefit from a prostate exam that is covered by health insurance. In addition, the PSA value It is identified, and it is one of the most frequently offered individualized health services (IGeL). However, the value of blood is frequently criticized.

What is the value of a PSA?

In the PSA . test It’s one blood test. In this context, PSA stands for “prostate-specific antigen”. measured PSA . protein concentrationWhich Only in the prostate I have been. Here it dilutes the sperm fluid so that the sperms remain motile. Some PSA also enters the blood and can be detected with a PSA test. A small percentage of PSA is freely dissolved in the blood, but the greater part binds to certain proteins and forms so-called compounds. The free and bound part is called Total PSA It is referred to, or in common parlance as “PSA”. The value is given in nanograms per milliliter (ng/ml). The goal of determining the value of the PSA is Rule out possible prostate cancerTumor, if possible To get to know early or the a path From prostate cancer to to log in.

What does the PSA value say?

Most doctors use the PSA value to diagnose prostate cancer because Cancer cells produce more PSA of healthy prostate cells. However, there is still no generally accepted cut-off value for PSA in healthy men. In addition to PSA increases with age Naturally. In addition, the PSA value is not a specific marker of cancer that definitely indicates prostate cancer. In sure men Medicinesuch as the 5-alpha reductase inhibitors prescribed for BPH, can increase PSA levels minimum stand out. However, the value can also be high is being:

note: Therefore prostate cancer cannot be completely excluded with a low total PSA value, and a high total PSA value is not considered evidence of prostate metastasis. and then PSA measurement alone is not meaningful enoughto make a diagnosis.

Reference values ​​for total PSA are based on age:

  • 40-49 years: 2.5 ng/ml
  • 50 to 59 years: 3.5 ng/ml
  • 60 – 69 years: 4.5 ng/ml
  • Over 70 years old: 6.5 ng/ml

How dangerous is prostate cancer?

The following facts explain the importance of prostate cancer:

  • Around 60,000 men get sick New every year.
  • Around 13,000 men die Every year from prostate cancer, so one in five dies from the disease.
  • Prostate cancer is cancerThis is in men The second most deadly runs.
  • If siblings or parents have already been diagnosed with prostate cancer, there is one for those affected Four to five times the riskto develop prostate cancer on their own.

However, at the same time, the following also applies:

  • Most prostate cancer occurs in over 60 years old on me.
  • The tumor often grows faster slow.
  • Many patients do not die from the tumor, but rather from it With prostate cancer.
  • Cancer will It was recognized earlyCure is possible in more than 70%.

For this reason, the German Urological Society recommends screening for early detection of prostate cancer in men from the age of 45 Palpation and determination of the PSA value.

Why is the PSA value often criticized?

  • Health insurance companies pay examination fees only in certain cases: The PSA test for early detection Most German health insurance companies do not cover men who do not have symptoms. Costs will be covered only if a Significant suspicion of cancer Present. For example, when checking by touch Recognized changes will. The costs for tissue samples and ultrasound examinations are then also paid for.
  • Several harmless neoplasms were detected: On the other hand, regular PSA testing can help reduce the risk of dying from prostate cancer. On the other hand, many harmless tumors have been found I don’t need treatment be. For this reason, biopsies and surgeries are frequently performed, which may increase the risk of enuresis and impotence. The Consumer Counseling Center reports that out of every 1,000 men who receive a PSA test, approximately one to two men are saved from death.
  • Prostate cancer is not always fatal: Although prostate cancer is one of the most common malignancies in men, the risk of death from it is lower. One reason is that malignant cancer cells just grow slowly It is often men who come first in old age fell ill. Therefore, many die not from the tumor, but from the tumor. The cause of death is often different.
  • The risk of ‘false positives’ is high: An elevated PSA level can also be due to a Another reason Increase, such as benign prostatic hyperplasia or exposure to stress. As a result, patients are often unnecessarily stressed.

What do experts say about this?

The The S3 Interdisciplinary Guide to Prostate Cancer Therefore the German Society of Urology and the German Cancer Society explicitly recommend that when diagnosed with prostate cancer, a untreated under normal control It represents a reasonable alternative. However, other factors such as the type and size of prostate cancer, PSA value, palpation, age and general health or wishes of the man must be considered. this is “active monitoring or “waiting to watch” Especially useful if the probability of a man dying from prostate cancer is rather low. Treatment is recommended when prostate cancer has spread violent They act and there is a high probability that they keep growing and yourself It spreads in the body.

Important before performing a PSA test: Avoid prostate irritation in the days before the test. Biking, having sex, and straining when you have a bowel movement can alter your PSA level.

Risk-adapted PSA screening may be the future

The risk-adjusted PSA screen is a The most effective early detection program with fewer side effects for prostate cancer. It is recommended that the PSA value be determined once at age 45 or at least at age 50 for latent To be able to specify, to any other tests that can be referenced later.

Study investigates the optimal age for first PSA evaluation

  • so called PROBASE Study Inquiry What is the optimal age for determining baseline PSA – 45 or 50 years? The study included more than 46,000 men aged 45 and over, who were divided into two different groups.
  • Their PSA was determined at the start of the study, with three high-risk groups emerging: low risk (<1.5 ng/ml of blood), medium risk (1.5-2.99 ng/ml), high risk (≥3ng/ml). If another test shows a high risk again, the patient is advised to take a Prostate biopsy I would have done. Low- and moderate-risk men should repeat the PSA test every five and two years, respectively.
  • The other half of the subjects were initially given a haptic examination Offered to the prostate. PSA must be determined only once 50 years old take place.
  • The study is expected to run until 2035. Until then, researchers can compare how many tumors have been detected, at what stages, and at what age. The first results were published in the International Journal of Cancer.


  • Personal protective equipment Prostate-specific antigen (PSA) is a protein It is made by the prostate glands And the It was detected in the blood It can be measured. With age, the level of PSA in the blood increases slightly. However, the value increases significantly at a acute prostatitis It increases moderately to a large extent when a Prostate cancer Present. Thus, determining the value of PSA in the blood Indicates the presence of prostate cancer.
  • However, factors that irritate the prostate can also lead to a moderate increase in PSA. These include, for example, cycling, sexual intercourse and a physical examination shortly before the PSA value is taken.
  • joint sight PSA value along with haptic examination under consideration prostate volumepossible infections and the patient’s age However, allow conclusions to be drawn about the likelihood of developing prostate cancer. Then it can determine whether a file Prostate tissue sample (biopsy) is useful to confirm or eliminate this suspicion.
  • During palpation of the prostate alone, malignant changes are reliably detected only in areas of the prostate located near the rectum and only the first Of the size not less than about 1 cm. Hence, PSA examination Valuable additional information Availability for the presence of prostate cancer. If prostate cancer is detected in the early stages, there is 70% chance of recovery.
  • Men are advised to do so Prostate examination from the age of 45To be performed in a urology clinic. The PSA value becomes frequent if the palpation results are not noticeable Not covered by health insurance. Health insurance companies do not pay for this examination unless there is a significant suspicion of cancer.
  • Patients should decide individuallyWhether an additional PSA test should be performed if no changes are found on palpation. In addition, they must have Possible consequencesLike a biopsy later, talk to your doctor.

Reading tip: Is your prostate healthy? Here’s how you can test it out for yourself!

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