Information: After abnormal PSA test

After an abnormal PSA test, your doctor will likely start with a follow-up PSA test in 6 weeks to a few months to see if the level was a temporary elevation. If it remains high, the next steps typically involve a digital rectal exam (DRE) and a prostate MRI, which can help identify suspicious lesions. If the imaging shows a suspicious area, your doctor will likely recommend a prostate biopsy, the only way to definitively diagnose prostate cancer

Immediate next steps

  • Follow-up PSA test: Your doctor will likely schedule a repeat test to see if the high level was a one-time event, as things like infection or inflammation can temporarily raise PSA levels
  • Digital rectal exam (DRE): Your doctor will perform a DRE to check the prostate for any lumps, hard spots, or other structural abnormalities.

 

Further evaluation (if PSA remains elevated)

  • Prostate MRI: A high-quality MRI can help identify suspicious lesions and guide a future biopsy. It may also be sufficient to rule out cancer if the prostate looks normal.
  • Biopsy: If the DRE or MRI reveals a suspicious area, a biopsy is often necessary for a definitive diagnosis.
    • A traditional biopsy involves taking random samples.
    • An MRI-ultrasound fusion biopsy uses MRI images to guide the needle to the exact location of suspicious areas, making it more accurate.

 

What to do next

  • Understand the results: The biopsy will determine if cancer is present. If it is, the results will be used to “stage” the cancer (determine how advanced it is) and plan treatment.
  • Discuss options with your doctor: If prostate cancer is diagnosed, your doctor will discuss your options, which can range from active surveillance to surgery, radiation, or other treatments depending on the aggressiveness of the cancer.
  • Talk to a urologist: It is common for your primary care doctor to refer you to a urologist for a more in-depth evaluation and to guide the next steps.

The information is adapted from National Comprehensive Cancer Network. (2026). NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer Early Detection (Version 1.2026). Available at https://www.nccn.org/text generated by Gemini.” Gemini, Google, 19 Nov 2025 and from OpenAI on 11/19/2025 using “what to do after abnormal prostate cancer screening result  in plain language”

This information provides no warranties regarding the accuracy or application of its content, disclaims responsibility for its use, and does not offer medical or legal advice. It does not endorse specific products or therapies, mandate medical care, or represent the standard of care. The information may not be continually updated, and it is not a substitute for the professional judgment of a treating provider. Provided “as is,” it makes no express or implied warranties, assumes no responsibility for any harm arising from its use, and disclaims liability for errors or omissions.