What is PSA Density?

PSA density (PSAD) is the ratio of your total PSA level to the volume of your prostate (measured in cubic centimeters or cc).

PSA Density = Total PSA (ng/mL) ÷ Prostate Volume (cc)

It helps adjust for the fact that larger prostates naturally produce more PSA, even in the absence of cancer.

 Why is PSA Density Useful?

Some men may have an elevated PSA simply because their prostate is large (due to benign prostatic hyperplasia or aging). PSA density helps determine if the PSA level is higher than expected for the gland size, which may raise suspicion for prostate cancer.

A man with a PSA of 6.0 ng/mL and a very large prostate (e.g., 80 cc) may have a low PSA density, suggesting a benign cause.
In contrast, a PSA of 6.0 ng/mL with a small prostate (e.g., 25 cc) may reflect a more suspicious finding.

How to Interpret PSA Density:

PSA Density (ng/mL/cc)

Interpretation

< 0.15 : Lower likelihood of cancer

≥ 0.15 : Higher likelihood of cancer

A PSA density above 0.15 is often used as a threshold to consider MRI or prostate biopsy.

Example:

• Total PSA = 7.2 ng/mL

• Prostate Volume (from ultrasound or MRI) = 32 cc

• PSA Density = 7.2 ÷ 32 = 0.22 ng/mL/cc

This result exceeds the 0.15 threshold and may prompt further evaluation, such as imaging or biopsy, even if the total PSA alone doesn’t seem very high