{"id":315883,"date":"2025-11-14T13:35:17","date_gmt":"2025-11-14T13:35:17","guid":{"rendered":"https:\/\/www.pierluigibove.com\/2025\/11\/14\/professor-pierluigi-bove-explains-psa-between-myths-legends-and-clinical-reality\/"},"modified":"2026-01-13T16:25:11","modified_gmt":"2026-01-13T16:25:11","slug":"professor-pierluigi-bove-explains-psa-between-myths-legends-and-clinical-reality","status":"publish","type":"post","link":"https:\/\/www.pierluigibove.com\/en\/2025\/11\/14\/professor-pierluigi-bove-explains-psa-between-myths-legends-and-clinical-reality\/","title":{"rendered":"Professor Pierluigi Bove explains PSA: between myths, legends, and clinical reality"},"content":{"rendered":"\n

How to correctly interpret the most debated test in prostate health<\/p>\n\n\n\n

The PSA test (prostate-specific antigen) continues to generate discussion, doubts, and at times unjustified fears. Many men wonder whether it is truly useful, how often it should be performed, and what its real meaning is. Professor Pierluigi Bove clarifies that PSA still represents today the reference tool for prostate screening and monitoring, but it must be interpreted with expertise and contextualised within the overall clinical framework by the urologist. <\/strong>.<\/p>\n\n\n\n

\u201cPSA,\u201d explains Professor Bove, \u201cis an organ-specific marker, but not a disease-specific one.<\/strong> This means that a high value does not necessarily indicate cancer:<\/strong> it may be related to many other benign conditions.\u201d<\/p>\n\n\n\n

What PSA is<\/p>\n\n\n\n

PSA is an enzyme<\/strong> belonging to the kallikrein family that is produced by the prostate and normally serves as an anticoagulant for semen. PSA can be measured in the blood, and its \u201cnormal\u201d value generally falls within a range between 0 and 4 ng\/ml.<\/strong> Attention, however: several conditions other than cancer\u2014such as benign prostatic hyperplasia (BPH), inflammation (prostatitis), prostatic manipulation (massage, instrumental examinations), recent ejaculation, or intense physical activity (especially cycling)\u2014can significantly alter its value. <\/p>\n\n\n\n

Not the number itself, but its history<\/p>\n\n\n\n

A common mistake is to consider a single PSA value. In reality, what matters is its trend over time, the size of the prostate, and the presence or absence of urinary symptoms. For this reason, PSA evaluation cannot be left to the patient or the general practitioner, but must be integrated and interpreted by the urologist.<\/strong> <\/p>\n\n\n\n

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    \u201cIt is not the single value that tells us something,\u201d Professor Bove specifies, \u201cbut its behaviour over time (PSA velocity, PSA doubling time). Sometimes we are interested in observing its evolution over two years, not over three or six months.\u201d<\/p>\n\n\n\n

    A practical example: 10 ng\/ml may be a \u201cnormal\u201d value if it has already been observed and has remained substantially stable for many years. Conversely, 3.5 ng\/ml may be suspicious if in previous years the value was much lower. <\/p>\n\n\n\n

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    Mistakes to avoid: too often or too late<\/p>\n\n\n\n

    PSA should not be treated like a simple blood count<\/strong> that is repeated routinely. Performing it too frequently can generate false alarms, resulting in anxiety and unnecessary investigations. On the other hand, postponing it too long can delay important diagnoses. <\/p>\n\n\n\n

    According to the guidelines of the European Association of Urology (EAU),<\/strong> the frequency of testing depends on age, family history of cancer, and baseline values.<\/p>\n\n\n\n