From the Guidelines
Running within the last 2 days is not contraindicated for PSA testing, as moderate exercise like running has minimal impact on PSA results. According to the most recent study published in the British Journal of Cancer in 2024 1, physical activity, especially acute exercise, may increase serum prostate-specific antigen (PSA) concentration, but habitual physical activity may be associated with lower PSA concentration. However, this study also suggests that the impact of physical activity on PSA levels is still being researched, and more evidence is needed to fully understand the relationship.
When considering PSA testing, it's essential to follow guidelines that prioritize accurate test results. The 2018 clinical practice guideline published in the BMJ 1 recommends avoiding vigorous exercise, such as cycling, in the 2 days prior to PSA testing, as this may result in false positive elevation. However, running is not specifically mentioned as a contraindication.
To ensure accurate PSA test results, it's recommended to:
- Avoid ejaculation for 48 hours before the test
- Avoid prostate manipulation (such as digital rectal examination or prostate biopsy) for several days before testing
- Inform your healthcare provider about any current urinary tract infections or prostatitis, as these conditions can significantly elevate PSA levels
- Avoid activities that directly traumatize the prostate, such as cycling (due to pressure on the perineum)
Overall, running and other forms of exercise that don't directly impact the prostate should not interfere with your PSA test results, and you can safely undergo a PSA blood test even if you have recently engaged in running or other forms of exercise.
From the Research
Running and PSA Testing
- Running within the last 2 days may affect PSA test results, as physical activity has been shown to increase serum PSA concentrations 2, 3, 4.
- A study found that marathon running caused a significant increase in total PSA levels in 11% of participants, although the average total and free PSA concentrations did not change significantly 2.
- Another study found that standardized exercise on a bicycle ergometer increased serum PSA concentrations by up to threefold, with the increase being age-dependent and correlated to the PSA concentration before exercise 3.
- A study on the influence of physical exercise on PSA concentrations in elderly men with elevated PSA levels and benign prostate hyperplasia found that cycling exercise significantly increased total PSA levels, with an average increase of 25% 4.
- The study also found that the levels of PSA returned to the basic level 48 hours after the cycling test, but in individual cases, it took longer 4.
Recommendations for PSA Testing
- Men should abstain from physical exercise, especially cycling, for several days and at least for 24 hours before PSA measurements are carried out, especially for patients with elevated PSA levels (>4 ng/ml) 4.
- The increase in PSA concentrations after physical activity may lead to false positives, and repeat measurements should be considered at a time significantly removed from such exercise 2, 3.
- The effect of physical activity on PSA concentrations should be taken into account when interpreting PSA test results, and a sudden rise in PSA may suggest prostatitis, which could be further evaluated before biopsy 5.