Cancer Surgery
July 2, 2026
5 min read

What is the PSA Test? Which Values Require a Biopsy?

Op. Dr. Fettah Tosun

Op. Dr. Fettah Tosun

Üroloji Uzmanı

PSA (Prostate-Specific Antigen) is a protein produced by cells in the prostate gland and measured in the blood. It is the most important screening tool used in the early diagnosis of prostate cancer. However, a high PSA does not always mean cancer.

Causes That Increase PSA Value

PSA is prostate-specific, not cancer-specific. Therefore, conditions such as prostate enlargement (BPH), prostate inflammation (prostatitis), urinary tract infections, urinary catheter insertion, or sexual intercourse can also increase the PSA value.

Which PSA Values Require a Prostate Biopsy?

  • Standard Threshold (4 ng/ml): Generally, a PSA value above 4 ng/ml is considered suspicious, but the limit is lower in younger patients.
  • PSA Velocity: The rate of increase of PSA value over time strengthens the suspicion of cancer.
  • Free/Total PSA Ratio: If the PSA value is between 4-10 ng/ml and the free PSA ratio is below 15-20%, the probability of cancer increases, and MR-fusion biopsy is recommended.
  • Before panicking about high PSA, a detailed physical examination should be performed by a urologist, and Multiparametric Prostate MRI should be obtained when necessary.

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