Noncancerous Causes of High PSA Levels
CancerProstate Cancer

What Does a High PSA Level Mean?

What Does a High PSA Level Mean?
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Updated on September 25, 2026
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A prostate-specific antigen (PSA) test is one tool that doctors use to screen for prostate cancer. This small gland is located between the bladder and the penis in men. Healthcare professionals may administer the test if you’re experiencing symptoms like an enlarged prostate, dull pain in the lower pelvic area, frequent urination, or pain or difficulty while urinating.

Depending on your age and risk factors for prostate cancer, your doctor may also recommend a PSA test as part of routine preventive care. The test involves taking a blood sample and measuring the level of prostate-specific antigen, a type of protein that both normal and cancerous prostate gland cells produce. Higher levels of this antigen may be a sign of prostate cancer in some people.

But the test isn’t perfect — sometimes PSA levels are high when no cancer is present.

 Keep reading to learn about the many common reasons besides prostate cancer that PSA levels might be elevated.

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Testing for Prostate Cancer

Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer.

 In many cases, prostate cancer grows slowly and remains in the prostate gland, where it may not be life-threatening. But some types of prostate cancer can be aggressive, spread to other areas of the body, and become deadly.

Prostate cancer may not have any obvious symptoms in the early stages, which is one reason why screening can be useful. Diagnosing the cancer before it’s had the chance to spread to other parts of the body means that it will be easier to treat and potentially cure.

In general, the higher a person’s PSA, the more likely it is that they have cancer. But a low PSA blood level isn’t a guarantee that you don’t have prostate cancer, and a higher level is not definitive proof of cancer either. What’s more, the test can appear abnormal even when there is no cancer, a phenomenon known as false positive. People with false positive results for cancer may have high PSA levels because of other conditions.

Because many prostate cancers are slow-growing and not life-threatening, there’s also a risk of overtreatment — when a person undergoes treatment that can have risks and side effects for a cancer that may not ever have caused problems or shortened their life.

Because of these considerations, it can be difficult to know exactly when to start screening for prostate cancer. There isn’t a consensus among the medical community on when to perform PSA tests for prostate cancer, and the recommendations can change over time.

The most recent guidelines from the American Urological Association recommend that routine screening begins at age 45 to 50 in men at average risk. For those at higher risk, including African Americans and those with a strong family history of prostate cancer, screening should begin at age 40 to 45, the guidelines state. The recommendations emphasize shared decision-making, encouraging doctors to talk through a patient’s values, risk factors, and preferences before ordering a PSA test.

Ideally, doctors recommend a PSA test for men who have at least 10 years of life expectancy or who are undergoing evaluation for metastatic prostate cancer, says Amin Herati, MD, an assistant professor of urology and the director of male infertility and men’s health at Johns Hopkins Medicine in Baltimore.

“In general, we recommend screening men aged 55 to 69 years, unless a male has a higher risk of prostate cancer (a family history, being of African American descent), in which case we screen at age 50,” he says. This aligns with guidelines from the U.S. Preventive Task Force, an independent panel of national experts under the U.S. Agency for Healthcare Research and Quality.

Remember, it’s important to discuss the risks and benefits of prostate cancer screening with your doctor before you have a PSA test. For men who choose to take the test, your provider will discuss your results and the next steps.

Noncancerous Causes of a High PSA Test Result

In some cases, PSA levels could be above normal for reasons other than cancer.

Aging

Even without any prostate problems, your PSA level can increase gradually as you age. “We use age-based cutoffs to determine normal levels,” says Dr. Herati.

He says that doctors consider a PSA score greater than 2.5 to be abnormal for men in their forties and fifties, and above 4 is abnormal for men in their sixties.

“Remember that a PSA can be a normal range but show a fast rise when followed year to year. This would be considered abnormal and prompt additional investigation,” says Herati.

Prostatitis

One culprit for higher PSA levels can be a type of inflammation in the gland called prostatitis, a common problem in men under 50.

Prostatitis is inflammation of the prostate gland, and about half of all men have symptoms at least once in their lifetime. Symptoms can include pain or discomfort in the prostate gland and pain or burning during urination.

There are several different types of prostatitis, and the treatments can vary according to the type. While antibiotics can treat bacterial prostatitis, the more common type, called nonbacterial prostatitis, can be harder to treat because doctors often do not know the exact cause. It could develop due to a number of factors, including:

  • Inflammation
  • Nerve damage
  • Pelvic muscle damage
  • Viruses
Even stress and emotional problems can contribute to nonbacterial prostatitis.

Sometimes, complex and personalized treatments are necessary. Even then, nonbacterial prostatitis can become a chronic condition, which means it persists even after treatment. Men should contact their doctor right away if they have symptoms of prostatitis.

Medical Procedures

“Anything that traumatically interferes with the architecture around the prostate gland can make PSA go up,” says John Milner, MD, a urologist in the Chicago area. “One of the most common causes of significantly high PSA from this type of trauma is the placing of a catheter into the bladder.” A catheter might be placed before surgical procedures or because of urinary issues.

But a catheter placed without trauma is unlikely to change the PSA significantly, says Herati. “A three-day period is often sufficient time for a transient increase to dissipate,” he adds.

Another cause of elevated PSA levels is a cystoscopy, a procedure in which a medical professional places a long, thin, flexible, lighted tube called a cystoscope in the urethra and moves it up into the bladder. This procedure allows your healthcare provider to look at the urinary tract and detect early signs of cancer, infection, narrowing, blockage, and bleeding. A bladder biopsy (which can occur as part of a cystoscopy) may also cause PSA levels to rise.

Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is an enlargement of the prostate gland, but it’s not prostate cancer. The condition is more common with age, and while benign, it can cause uncomfortable symptoms like frequent urination, a weak urine stream, and urinary tract infections (UTIs).

BPH can also cause elevated PSA levels.

Your doctor may order additional tests, such as a rectal exam, MRI, ultrasound, or further PSA testing to determine if the cause of elevated PSA is a benign condition or something more worrisome.

Urinary Tract Infection

“A urinary tract infection can cause higher than normal PSA levels,” says Herati. The reason that the levels rise is not clear, but infections may cause the membranes that separate the prostate from the blood supply to be more permeable, he says.

Because of this, it’s advised to wait until a diagnosed UTI has cleared up before getting a PSA test.

Ejaculation

“Ejaculation can cause a mild elevation of your PSA level, and so can having a digital rectal exam,” says Dr. Milner. “These types of PSA elevations are usually not enough to make a significant difference, unless your PSA is borderline. PSA should return to normal in two to three days.”

To avoid this type of elevation, doctors will usually draw blood for a person’s PSA level before doing a rectal exam. Ask your doctor if you should avoid ejaculation for a few days before a PSA test.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. What Are the Top 5 Warning Signs of Prostate Cancer? UT MD Anderson. January 10, 2024.
  2. Prostate-Specific Antigen (PSA) Test. National Cancer Institute. January 31, 2025.
  3. Key Statistics for Prostate Cancer. American Cancer Society. January 13, 2026.
  4. Prostate Cancer. Cleveland Clinic. May 21, 2025.
  5. Prostate Cancer Screening. MedlinePlus. August 23, 2024.
  6. Lin DW et al. Early Detection of Prostate Cancer: AUA/SUO Guideline (2026). American Urological Association. 2026.
  7. Prostate Cancer Screening. U.S. Preventive Task Force. May 8, 2018.
  8. Prostate-Specific Antigen (PSA) Levels by Age: What to Know. UT MD Anderson. March 18, 2024.
  9. Prostatitis. Cleveland Clinic. November 14, 2023.
  10. Prostatitis – Nonbacterial. MedlinePlus. July 1, 2025.
  11. Urinary Catheters. MedlinePlus. January 1, 2025.
  12. Cystoscopy for Men. University of Rochester Medicine.
  13. Benign Prostatic Hyperplasia. Mayo Clinic. December 23, 2025.
  14. Elevated PSA (Prostate-Specific Antigen) Level. Cleveland Clinic. April 24, 2024.
  15. What Is a PSA Test? Understanding Prostate-Specific Antigen. Prostate Cancer Foundation.
  16. Screening Tests for Prostate Cancer. American Cancer Society. November 22, 2023.
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Christopher Wolter, MD

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Christopher Wolter, MD, is an assistant professor in urology at Mayo Clinic in Phoenix, Arizona. He has been in practice since 2008, specializing in the areas of urinary incontinen...

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Chris Iliades, MD

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Chris Iliades, MD, is a full-time medical writer and journalist based in Boothbay Harbor, Maine. He practiced clinical medicine for 15 years before transitioning to medical writing...

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