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PSA Prostate Specific Antigen Free & Total

 
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Description
 

CPT Code(s)

84153, 84154

Includes

Total PSA, Free PSA, % Free PSA (calculated)

Methodology

Immunoassay (IA)

Limitations

Based on solid evidence, screening with PSA and/or DRE detects some prostate cancers that would never have caused important clinical problems. Current prostate cancer treatments, including radical prostatectomy and radiation therapy, result in permanent side effects in many men. The most common of these side effects are erectile dysfunction and urinary incontinence. Whatever the screening modality, the screening process itself can lead to adverse psychological effects in men who have a prostate biopsy but do not have identified prostate cancer. Prostatic biopsies are associated with complications, including fever, pain, hematospermia/hematuria, positive urine cultures, and rarely sepsis.

Reference Range(s)

Total PSA ≤4.0 ng/mL
% Free PSA>25 % (calc)

Clinical Significance

In men over 50 years with total PSA between 4.0 and 10.0 ng/mL, the percent (%) free PSA gives an estimate of the probability of cancer. In these circumstances the measurement of the % free PSA may aid in avoiding unnecessary biopsies.


Elevated levels of Prostate Specific Antigen (PSA) have been associated with benign and malignant prostatic disorders. Studies indicate that in men 50 years or older measurement of PSA is a useful addition to the digital rectal exam in the early detection of prostate cancer. In addition, PSA decreases to undetectable levels following complete resection of the tumor and may rise again with recurrent disease or persist with residual disease. Thus, PSA levels may be of assistance in the management of prostate cancer patients.

Alternative Name(s)

Fractionated PSA,Prostate Specific Antigen Free and Total,PSA, Free,Free PSA and Total PSA,PSA II


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