Non-Cancerous Causes of a High PSA

A higher than average PSA level doesn't always signify cancer

Each year, thousands of men are told they have a high PSA level after undergoing a routine screening test. If you've had a higher than average test result, you may be wondering what it means. The most important and most concerning cause of an elevated PSA is prostate cancer.  However, prostate cancer is only one of many potential causes of an elevated PSA.

If your PSA is higher than it should be, talk to your doctor about any further testing you may need. Some procedures and activities can cause a false positive. If you believe your results may be falsely elevated, you can ask your doctor to draw your blood again and have your PSA re-checked.

Benign Prostatic Hyperplasia (BPH)

Doctor examining senior man
Frank van Delft/Cultura/Getty Images

Benign prostatic hyperplasia is also commonly referred to as an enlarged prostate. BPH is a non-cancerous increase in the size and amount of cells within the prostate. It is extremely common in older men and, unlike cancer, has no risk of spreading throughout the body. In addition to causing elevated PSA levels, BPH can also cause a host of urinary symptoms including urgency and frequency. 

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Prostatitis is a condition where the prostate becomes inflamed due to an infection or another cause. Most cases of this condition are acute, or come and go away again over a short period of time, but you can also develop chronic prostatitis. This condition, if due to a bacterial infection, can be treated with antibiotics. 

Other types of bacterial infections, like a urinary tract infection (UTI), can also lead to your PSA appearing higher.

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Prostate Biopsy

If you have recently had a prostate biopsy, you will likely have artificially elevated PSA levels. Because of this, most physicians will draw blood for the PSA test before any biopsies are done. Also, after a biopsy, most physicians will wait a few weeks before taking another PSA level in order your PSA drop back to a baseline level.

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Recent Ejaculation

Ejaculation (the ejecting of semen from the penis) can cause a mild increase in the PSA level. Because of this, most physicians will advise you to avoid any sexual activity for at least a couple of days before your PSA blood test.

Digital Rectal Exam (DRE)

A digital rectal exam may cause a small increase in your PSA level. Your doctor will most likely draw blood before your doing a rectal exam to avoid a falsely-elevated rate.

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Bicycle Riding

Some studies have shown that strenuous bicycle riding can mildly elevate the PSA level over the short term. Because of this, you should avoid this activity for a few days prior to the PSA test.

Cystoscopy and Catheritization

Certain bladder procedures and interventions can also cause your PSA levels to appear higher than normal. Cystoscopy, a procedure where a thin scope with a camera is inserted into your urethra up into the bladder, can elevate PSA levels. Catheterization, the insertion of a thin tube into the urethra and bladder used to drain urine, can also lead to a higher PSA level.

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