What does a Prostate Specific Antigen (PSA) level of 0.58 micrograms per liter (ug/L) indicate about prostate cancer risk?

Interpretation of PSA Level 0.58 ug/L

A PSA level of 0.58 ug/L (0.58 ng/mL) is well within normal range and indicates very low risk for prostate cancer. This value is significantly below the traditional threshold of 4.0 ng/mL used for prostate cancer screening and even below the more conservative threshold of 2.5 ng/mL recommended in some guidelines 1.

Risk Assessment Based on PSA Value

• PSA 0.58 ng/mL falls into the lowest risk category:
  • Values below 1.0 ng/mL have only a 6.6% prevalence of prostate cancer 2
  • The risk of high-grade cancer at this PSA level is minimal, with studies showing only 12.5% of cancers detected at PSA levels ≤0.5 ng/mL being high-grade 2

Clinical Implications

Follow-up Recommendations

• Routine screening interval: With this low PSA value, screening can safely be extended to every 2 years rather than annually 1
  • The American Cancer Society guidelines support extending screening intervals for men with PSA levels below 2.5 ng/mL 1
  • The risk of conversion to a PSA above 4.0 ng/mL within 2 years is extremely low (only 0.24% for men with initial PSA of 1.0 ng/mL) 1

No Need for Immediate Additional Testing

• At this PSA level:
  • No indication for prostate biopsy
  • No need for additional imaging studies
  • No need for more frequent PSA monitoring

Context of PSA Interpretation

Age-Related Considerations

• PSA levels typically increase with age due to benign prostatic hyperplasia
• A value of 0.58 ng/mL would be considered very low regardless of age
• Even using age-specific reference ranges, this value would be well within normal limits for any age group 1

Other Factors That Can Affect PSA Levels

• Medications like finasteride or dutasteride can lower PSA values by approximately 50% 3
• Recent prostatitis, ejaculation, urinary retention, or prostate manipulation may temporarily elevate PSA levels 3
• Certain physical activities (bicycle riding, horseback riding) can transiently increase PSA 3

Post-Treatment PSA Interpretation (If Applicable)

If this PSA value is being measured after treatment for prostate cancer:

• After radical prostatectomy:

  • PSA should be undetectable (<0.1 ng/mL)
  • A value of 0.58 ng/mL would be concerning for biochemical recurrence 1

• After radiation therapy:

  • PSA should reach a nadir and remain stable
  • Biochemical recurrence is defined as PSA ≥2.0 ng/mL above nadir 1

Conclusion

This PSA value of 0.58 ng/mL represents a very low risk for prostate cancer in a screening context. Continued routine screening at extended intervals (every 2 years) is appropriate unless other risk factors are present, such as family history of prostate cancer or African American ethnicity 1.