PSA Density: The Key to Interpreting PSA Levels
A high PSA level doesn't always mean cancer. It could simply mean you have a large prostate. PSA Density (PSAD) is the metric that tells the difference.
What is PSA Density?
PSA Density is a calculation that divides your PSA level (Prostate-Specific Antigen) by the volume of your prostate.
Why It Matters: BPH vs. Cancer
Both Benign Prostatic Hyperplasia (BPH) and Prostate Cancer cause PSA levels to rise. However:
- BPH (Enlarged Prostate): Produces PSA, but usually in proportion to its size. A large gland naturally produces more PSA.
- Prostate Cancer: Cancer cells produce significantly more PSA per unit of volume than benign tissue.
Therefore, if you have a high PSA but also a very large prostate, your PSA Density might still be low (normal). If you have a small prostate but a high PSA, your PSA Density will be high, indicating a higher risk of cancer.
Reference Chart: Interpreting Your Score
| PSA Density (ng/mL/cc) | Interpretation | Typical Recommendation |
|---|---|---|
| < 0.10 | Low Risk | Routine monitoring |
| 0.10 - 0.15 | Intermediate / Gray Zone | Monitor closely / Consider MRI |
| > 0.15 | Suspicious | Further investigation (MRI/Biopsy) often recommended |
Example
Patient A has a PSA of 6.0 and a prostate volume of 30cc.
Density = 6.0 / 30 = 0.20 (High Risk).
Patient B has a PSA of 6.0 and a prostate volume of 80cc.
Density = 6.0 / 80 = 0.075 (Low Risk).