Is a prostate‑specific antigen level of 0.526 ng/mL normal for a 55‑year‑old man without urinary symptoms or family history of prostate cancer?

PSA of 0.526 ng/mL in a 55-Year-Old Male: Normal and Low-Risk

This PSA level of 0.526 ng/mL is well below normal thresholds and indicates very low risk for prostate cancer, requiring only repeat testing in 2-4 years.

Risk Assessment

Your PSA level falls well within the normal range for your age group:

• The median PSA for men aged 50-59 is 0.7-0.9 ng/mL, and your value of 0.526 ng/mL is below this median 1
• Men with PSA <1.0 ng/mL have only a 0.5% risk of metastasis by age 85 and 0.2% risk of death from prostate cancer 2
• The cancer detection rate for PSA 0.0-2.0 ng/mL is approximately 10%, and even lower at your level 2
• At 4 and 8 years of follow-up, men with PSA <1.0 ng/mL had cancer risk of only 0.23% and 0.49% respectively 2

Recommended Management

Repeat PSA testing in 2-4 years is appropriate based on current NCCN guidelines 1, 2:

• The National Comprehensive Cancer Network specifically recommends repeat testing every 2-4 years for PSA <1 ng/mL in men aged 45-75 years 1, 2
• No biopsy or additional workup is indicated at this PSA level 2
• Digital rectal examination may be performed as part of routine screening but is not mandatory given your very low PSA 1, 2

Important Considerations

Use the same laboratory for future PSA testing 2:

• Laboratory variability can range 20-25% between different assays 2, 3
• Consistent use of the same assay ensures accurate longitudinal monitoring 2

Avoid PSA testing after certain activities 2, 3:

• Recent ejaculation, prostate manipulation, or urinary tract infection can substantially elevate PSA 2
• Testing should be postponed 3-6 weeks after such events 2

When to Consider Earlier Follow-Up (1-2 Years Instead)

While your current PSA does not require this, you should return for earlier testing if you have:

• First-degree relatives with prostate cancer (father, brother) 2
• African American ethnicity, which carries higher baseline prostate cancer risk 1, 2
• Development of urinary symptoms such as difficulty urinating, weak stream, or blood in urine 2
• Abnormal findings on digital rectal examination if one is performed 1

Medication Considerations

If you are taking finasteride or dutasteride (5α-reductase inhibitors for hair loss or enlarged prostate):

• These medications reduce PSA by approximately 50% 1, 3
• Your PSA should be doubled for accurate interpretation 1, 2
• However, even doubling your value (to ~1.0 ng/mL) would still be in the low-risk range 1