PSA density performs better than PSA above four ng/milliliter for detecting prostate cancer among a cohort of men undergoing prostate biopsy.
PSA density is calculated as the PSA level in nanograms per millimeter divided by the prostate volume in centimeters cubed and it is a known risk factor for adverse pathological findings at the time of radical prostatatectomy in patients with the biopsy Gleason score of 6.
PSA density is considered to be low risk if it is less than 0.15 ng/mL percm³.
Men who have larger prostates, logically, have more prostate cells and, in general, produce more PSA regardless of whether they have cancer or not.
The prostate’s volume is measured by trans rectal prostate ultrasound, and then the PSA level is divided by the size of the prostate to calculate the PSA density.
A high PSA density means that a relatively small volume of prostate tissue is making a lot of PSA.
A low PSA density means that a large volume of prostate tissue is making relatively little PSA.
A high PSA density indicates a higher risk of prostate cancer.
Not all experts agree that PSA density should change the way that a physician diagnoses, monitors or treats prostate cancer.
Overall, men found to have a high PSA density likely should be more vigilantly monitored for prostate cancer.