A guide to the interpretation of serum prostate specific antigen levels

Objectives: To review the factors that affect the concentration of prostate specific antigen (PSA) in the serum. Results: The discussion includes the structure of PSA; its distribution and metabolism; various analytical aspects of PSA measurements; the effects of clinical manipulations on PSA, including digital rectal examination, transrectal ultrasound, cystoscopy, biopsy and transurethral resection of the prostate; factors affecting PSA levels in health, in benign disease, and in prostate cancer; the effect of various treatments on PSA; and the issue of reference ranges. Conclusion: Laboratory staff and physicians must take many factors into consideration when interpreting PSA results. Article Outline