Any increase in PSA of how many ng/mL per year necessitates a referral?

A yearly increase in PSA levels of 0.7 ng/mL warrants a referral for further evaluation, particularly to assess for potential prostate cancer. This threshold is clinically relevant because such a significant rise can indicate disease progression or the development of malignancy, especially in patients who have a history of elevated PSA levels or prostate concerns.

The chosen value of 0.7 ng/mL is backed by clinical guidelines, which emphasize that while small fluctuations in PSA can be common and not necessarily imply a serious issue, a rise of this magnitude should prompt more immediate investigation. This includes referral to a urologist for further assessment, which may involve additional testing such as prostate biopsies or imaging studies.

In comparison, lesser increases in PSA, like 0.2, 0.5, or even 1.0 ng/mL, may not hold the same weight in clinical decision-making processes and can often be attributed to benign factors, such as inflammation or benign prostatic hyperplasia (BPH). Thus, the recommendation for a referral specifically highlights the importance of closely monitoring PSA trends over time, particularly the significance of a 0.7 ng/mL increase as a potentially critical indicator of prostate health issues.