Non-Cancerous Causes of an Elevated PSA

Many factors can cause an elevated PSA besides prostate cancer

prostate cancer
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Every year, thousands of men are told that they have a high PSA level, prostate-specific antigen level, after undergoing a routine screening test. 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. Virtually anything that irritates the prostate will cause your PSA to rise, at least temporarily.​

Non-Cancerous Causes of an Elevated PSA

  1. Benign Prostatic Hyperplasia (BPH)This benign (non-cancerous) condition, also known as an enlarged prostate, is extremely common in older men. Unlike cancer, BPH has no risk of spreading throughout the body.
  2. ProstatitisProstatitis 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 some men also can have chronic prostatitis. This condition, if due to a bacterial infection, can be treated with antibiotics.
  3. Prostate Biopsy: Men who have recently undergone a prostate biopsy will usually 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 a repeat PSA level in order to let the level drop back to a baseline level.
  1. 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.
  2. Digital Rectal Exam (DRE)The digital rectal exam may cause a small increase in the PSA level. Therefore, blood for the PSA test is usually drawn prior to this exam.
  1. 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.

Getting a False Positive Result 

It is also possible to get a false-positive–a false result that says your PSA is high when it is not. If your PSA is high without a known cause, your doctor will likely recommend an additional PSA test. Other items that can cause a falsely elevated PSA level include a recent urinary tract infection (UTI), recent catheterization (a thin tube inserted into the bladder through the urethra to drain urine from the bladder in men who have severe difficulties urinating), and a recent cystoscopy (the insertion of a thin instrument with a camera into the bladder). 

If you have engaged in any of the following activities within days before having your PSA levels tested, any elevated results may be a false positive. If you are concerned about the accuracy of your results, talk to your doctor and ask for a new blood test. 

Sources:

Crawford ED 3rd, Mackenzie SH, Safford HR, Capriola M.The Effect of Bicycle Riding on Serum Prostate Specific Antigen Levels. The Journal of Urology; 156 (1):103-105.

Keetch DW, Catalona WJ, Smith DS. Serial prostatic biopsies in men with persistently elevated serum prostate specific antigen values. The Journal of Urology 1994; 151(6):1571–1574.

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