For men in their 70s, understanding average PSA levels is a common concern. This article clarifies what PSA is, discusses typical ranges for this age group, explores factors that influence its levels, and outlines steps for navigating screening results.
Understanding PSA
PSA is a protein predominantly made by the prostate. Its primary biological function involves helping to liquefy semen, which allows sperm to move freely. While a small amount of PSA naturally circulates in the bloodstream, elevated levels can sometimes indicate a change in prostate health. Measuring PSA through a simple blood test serves as a biomarker to assess the prostate. The PSA test is not a direct diagnostic tool for prostate cancer; instead, it acts as an indicator that warrants further investigation if levels are higher than expected.
Average PSA Levels for 70-Year-Olds
PSA levels naturally increase with age, even without prostate cancer. Therefore, no single “normal” PSA reading applies universally. For men in their 70s, average PSA levels vary across medical guidelines. Some sources suggest a typical range for men aged 70 and above can extend up to 6.5 ng/mL, while other guidelines indicate 4.5-5.5 ng/mL might be considered normal for men between 70 and 80 years old. It is common for men in this age bracket to have a PSA level higher than 3 ng/mL, which can still be within a healthy range for their age.
Factors Influencing PSA and What High Levels May Indicate
Numerous factors beyond age can influence PSA levels. One common non-cancerous cause is Benign Prostatic Hyperplasia (BPH), a non-cancerous enlargement of the prostate gland prevalent in older men. As the prostate grows, it can produce more PSA, leading to higher readings. Prostatitis, an inflammation or infection of the prostate, can also cause a temporary increase in PSA levels. Urinary tract infections (UTIs) are another potential cause of elevated PSA.
Factors like recent ejaculation or vigorous exercise, such as cycling, can cause short-term elevations. Similarly, physical manipulation of the prostate, like during a digital rectal exam (DRE) or certain medical procedures, may also lead to a temporary rise in PSA. Only about 25% of men with PSA levels between 4 and 10 ng/mL are found to have prostate cancer upon biopsy.
Navigating PSA Screening and Next Steps
For men in their 70s, the decision to undergo PSA screening involves a careful conversation with a healthcare provider. This discussion considers individual health status, life expectancy, and personal preferences regarding the potential benefits and risks of screening. While screening can allow for early detection of prostate cancer, there are also potential downsides, including false positive results, which can lead to anxiety and additional invasive procedures. For example, a commonly used PSA cutoff of 4 ng/mL has a false-positive rate of around 70%.
If a PSA level is concerning, the next steps involve further evaluation. The first action is often to repeat the PSA test to confirm the elevation, as levels can fluctuate due to various non-cancerous factors. A digital rectal exam (DRE) may also be performed to physically assess the prostate for any abnormalities. If concerns persist, a referral to a urologist is common, who may recommend additional tests like a free PSA test or multiparametric MRI of the prostate. An MRI can help visualize the prostate more clearly and guide subsequent procedures if a biopsy is deemed necessary to definitively diagnose or rule out prostate cancer.