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HelpTest ID: SPSA Prostate-Specific Antigen (PSA) Screen, Serum
Reporting Name
Prostate-Specific Ag Screen, SUseful For
As a screening aid in the detection of prostate cancer when used in conjunction with a digital rectal exam in men 50 years or older
Screening to aid in the prognosis and management of individuals diagnosed with prostate cancer
Clinical Information
Prostate-specific antigen (PSA) is a glycoprotein produced by the prostate gland, the lining of the urethra, and the bulbourethral gland. Normally, very little PSA is secreted in the blood. Increases in glandular size and tissue damage caused by benign prostatic hypertrophy, prostatitis, or prostate cancer may increase circulating PSA levels.
In patients with previously diagnosed prostate cancer, PSA testing is advocated as an early indicator of tumor recurrence and as an indicator of response to therapy. The role of PSA in early detection of prostate cancer is controversial. The American Cancer Society recommends annual examination with digital rectal examination and serum PSA beginning at age 50 and for men with a life expectancy of at least 10 years after detection of prostate cancer. For men in high-risk groups, such as African Americans or men with a first-degree relative diagnosed at a younger age, testing should begin at a younger age. It is generally recommended that information be provided to patients about the benefits and limitations of testing and treatment so they can make informed decisions.
Interpretation
Prostate-specific antigen (PSA) values are reported with the 95th percentile limits by decade of age. These reference limits include men with benign prostatic hyperplasia. They exclude all cases with proven cancer.
PSA values exceeding the age-specific limits are suspicious for prostate disease, but additional testing, such as prostate biopsy, is needed to diagnose prostate pathology.
The minimal reporting value is 0.1 ng/mL. Values above 0.2 ng/mL are considered evidence of biochemical recurrence of cancer in men after prostatectomy.
Report Available
1 to 3 daysDay(s) Performed
Monday through Saturday
Clinical Reference
1. Grimsey P, Frey N, Bendig G, et al. Population pharmacokinetics of exogenous biotin and the relationship between biotin serum levels and in vitro immunoassay interference. J Pharmacokinet Pharmacodyn. 2017 Sept;2(4):247-256. doi:10.4155/ipk-2017-0013
2. Oesterling JE, Jacobsen SJ, Chute CG, et al. Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges. JAMA. 1993;270(7):860-864
3. Saint Paul LP, Debruyne D, Bernard D, Mock DM, Defer GL. Pharmacokinetics and pharmacodynamics of MD1003 (high-dose biotin) in the treatment of progressive multiple sclerosis. Expert Opin Drug Metab Toxicol. 2016;12(3):324-344. doi:10.1517/17425255.2016.1136288
4. Smith RA, Cokkinides V, von Eschenbach A, et al. American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin. 2002;52(1):8-22. doi:10.3322/canjclin.52.1.8
5. Barry MJ, Albertsen PC, Bagshaw MA, et al. Outcomes for men with clinically nonmetastatic prostate carcinoma managed with radical prostatectomy, external beam radiotherapy, or expectant management: a retrospective analysis. Cancer. 2001;91(12):2302-2314. doi:10.1002/1097-0142(20010615)91:12<2302::aid-cncr1262>3.3.co;2-g
6. Blute ML, Bergstralh EJ, Iocca A, Scherer B, Zincke H. Use of Gleason score, prostate specific antigen, seminal vesicle and margin status to predict biochemical failure after radical prostatectomy. J Urol. 2001;165(1):119-125. doi:10.1097/00005392-200101000-00030
7. Netto GJ, Epstein JI. Immunohistology of the prostate. In: Dabbs DJ, ed. Diagnostic Immunohistochemistry. 5th ed. Elsevier; 2019:588-623
8. Ilic D, Djulbegovic M, Jung JH, et al. Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ. 2018;362:k3519. doi:10.1136/bmj.k3519
Method Name
Electrochemiluminescent Immunoassay
Specimen Type
SerumOrdering Guidance
Free prostate-specific antigen (PSA) can be added to previously-submitted PSA screen specimen within 72 hours of performing the total PSA. Specimen must have been shipped frozen.
If both free and total PSA results are desired, order PSAFT / Prostate-Specific Antigen (PSA), Total and Free, Serum.
Necessary Information
Include patient's age.
Specimen Required
Supplies: Starstedt Aliquot Tube 5mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Red-top tube must be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.
2. Serum gel tube must be centrifuged within 2 hours of collection.
Specimen Minimum Volume
0.75 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Frozen (preferred) | 180 days |
| Refrigerated | 5 days |
Reference Values
Males:
|
Age (years) |
PSA upper limit (ng/mL) |
|
<40 |
≤2.0 |
|
40-49 |
≤2.5 |
|
50-59 |
≤3.5 |
|
60-69 |
≤4.5 |
|
70-79 |
≤6.5 |
|
≥80 |
≤7.2 |
Females: Not applicable
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
84153
G0103 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| SPSA | Prostate-Specific Ag Screen, S | 83112-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| SPSA | Prostate-Specific Ag Screen, S | 83112-3 |
Forms
If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.
mml-Neuroimmunology, mml-Neuro-oncology, mml-Pediatric