What is "PSA" in a medical checkup result? Explanation of its relationship to prostate cancer

A medical checkup is something you will undergo at least once every year. Many of you may see the item "PSA" in the results. What exactly does PSA stand for? In this issue, we will explain the PSA test in detail.

What is PSA?

PSA (prostate-specific antigen) is a type of enzyme produced in the prostate gland and found in semen. However, when cancer develops in the prostate, this PSA leaks into the bloodstream. Therefore, by measuring the PSA level in the blood, the presence of prostate cancer can be estimated.

Reference Values and Interpretation of PSA Tests

Generally, the reference value for PSA is 4 ng/mL or less. However, a PSA between 4 and 10 ng/mL is called the "gray zone," and the possibility of cancer cannot be ruled out; a PSA above 10 ng/mL is considered a strong suspicion of prostate cancer.

However, PSA values fluctuate depending on age and prostate size, so it is not possible to make a general judgment based on numbers alone. In addition, there are cases where a high PSA does not indicate prostate cancer, and conversely, prostate cancer may be detected even if the PSA is low.

Implications and Cautions of Taking a PSA Test

The PSA test is a useful screening test for the early detection of prostate cancer, but there are some caveats.

Risk of overdiagnosis: A positive PSA test does not necessarily mean that you have prostate cancer. Therefore, it is necessary to undergo a thorough examination, a process that may lead to side effects such as erectile dysfunction.

Low mortality: Prostate cancer has a lower mortality rate and progresses more slowly than other types of cancer. Therefore, even if detected early, there is no need to start treatment immediately, and the patient may be followed up.

In some cases, PSA testing is banned in the U.S.: In the U.S., PSA testing is banned in some areas due to overdiagnosis and harmful effects of treatment by PSA testing.

If you are not sure whether you should take a PSA test

The decision to have a PSA test should be based on personal values and consultation with your doctor.

Advantages: May lead to early detection of prostate cancer and improve prognosis with appropriate treatment.

Disadvantages: risk of overdiagnosis, risk of complications from a thorough examination, psychological burden

If you have concerns about taking the PSA test, consult your doctor and choose the testing method that best suits your situation.

Current Situation Concerning PSA Testing

There are pros and cons regarding PSA testing.

Opinions advocating the effectiveness of PSA testing: Studies have shown that PSA testing has reduced the mortality rate of prostate cancer, and the Japanese Urological Association has taken the stance that PSA testing should be more widely used.

On the other hand, there are those who question the necessity of PSA testing because of concerns about overdiagnosis and harmful effects of overtreatment by PSA testing.

Conclusion

The PSA test is a useful test for the early detection of prostate cancer, but it is not a panacea, and it is important to consult with your doctor based not only on the PSA test results but also on a comprehensive assessment of your age, family history, symptoms, and other factors.