Clinical Significance
PSA, Total with Reflex to PSA, Free - 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.

Preferred Specimen(s)
2 mL frozen serum

Minimum Volume
0.6 mL

Collection Instructions
Do not collect specimen after a transrectal biopsy, results may be falsely elevated

Transport Container
Transport tube

Transport Temperature
Frozen • Room temperature acceptable if received within 72 hours

Specimen Stability
Room temperature: 72 hours
Refrigerated: 72 hours
Frozen: 5 months

Includes
If Total PSA is between 4.0-10.0 ng/mL, then Free PSA will be performed at an additional charge (CPT code(s): 84154).

Methodology
Immunoassay (IA)

Reference Range(s)
PSA, Total
Male    ≤4.0 ng/mL
Female    Not established