NICE NG12 PSA thresholds by age
| Age | PSA referral threshold (ng/mL) |
|---|
| 40–49 | Above 2.5 |
| 50–59 | Above 3.5 |
| 60–69 | Above 4.5 |
| 70–79 | Above 6.5 |
Refer on the suspected cancer pathway if the prostate feels malignant on rectal examination, whatever the PSA.
Before you test
- Avoid testing within 6 weeks of a UTI or prostate biopsy.
- Avoid ejaculation and vigorous exercise for 48 hours.
- Finasteride and dutasteride roughly halve PSA after 6 months.
- Give balanced information about benefits and harms in men without symptoms.
Frequently asked questions
What is a normal PSA by age?
NICE NG12 uses thresholds of 2.5 (40s), 3.5 (50s), 4.5 (60s) and 6.5 (70s) ng/mL.
Does finasteride affect PSA?
Yes. It roughly halves PSA after about 6 months of treatment.
Should I refer for an abnormal DRE?
Yes. A prostate that feels malignant needs referral whatever the PSA.
References
- NICE. Suspected cancer: recognition and referral. NG12. nice.org.uk/guidance/ng12
- Prostate Cancer UK. PSA consensus statement for primary care, 2024.
MedToolbox supports, and does not replace, clinical judgement, national guidance and local policy.
