Prostate Specific Antigen (PSA) (Free / Complex / Total)

Clinical definition of the PSA test
PSA is a protein produced by the cells of the prostate gland. It is present in small quantities in the serum of men with healthy prostates.  PSA exists in two forms in the blood: free (not bound) and complexed (cPSA, bound to protein). PSA test is the total PSA that measures the sum of free PSA and cPSA in the blood. Elevated levels of PSA are an indicator of prostate cancer BPH, prostatitis, and other prostate disorders. This test is used to monitor prostate cancer.

Why is the PSA test done?
PSA test is done to screen asymptomatic and symptomatic men for prostate cancer, to help determine the necessity for a biopsy of the prostate, to monitor the effectiveness of treatment for prostate cancer and to detect recurrence of prostate cancer.

What are the common signs/symptoms when the PSA test is done?

  • Difficult, painful, and/or frequent urination
  • Back pain
  • Pelvic pain
  • Blood in the urine
  • Blood in the semen
  • Erectile dysfunction (impotence)
  • Bone pain (especially in the lower back, hips, or ribs)
  • Loss of bladder control.
  • Delayed or slow start of urination
  • Dribbling or leakage of urine, most often after urinating

Who should do the PSA test (Target population)?

Persons showing the above signs & symptoms and symptoms suggestive of prostate cancer.

What should I do before the complex PSA test?

Specimen type

Specimen collection procedure

Preparatory instructions before the test *

Serum (Blood Sample)


(Collection of blood from a vein, usually from the arm)

Avoid physical activities which apply unnatural pressure on the genitals.

Stop activities like cycling and horseback riding for three days before the PSA test. Pressure on the prostate can falsely increase the PSA test results.
Avoid ejaculation at least 24 hours before sample collection.

The sample should be collected prior to the digital rectal exam and prior to (or several weeks after) a prostate biopsy.

*Subjects suffering from any illness or on oral or injectable medications are advised to consult their physician prior to requesting any tests or procedures.

How do I interpret  PSA test results?

Reference Range*


0-04 ng/ml


04- 10ng/ml

Border line



‘*A Reference range is a set of values which helps the healthcare professional to interpret a medical test. It may vary with age, gender, and other factors. Reference ranges may also vary between labs, in value & units depending on instruments used and method of establishment of reference ranges’

Diseases/conditions related to the complex PSA test

  • Acute prostatitis
  • BPH (Benign prostatic hyperplasia)
  • Benign Prostatic Hyperplasia (BPH)
  • Urinary tract infection (UTI)

Other tests related to the complex PSA test

  • Digital Rectal Exam (DRE)
  • Tumor markers

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PSA (Prostate Specific Antigen)

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