Test library
Free and Total PSA Blood Test
This blood test measures total PSA, free PSA, and the free-to-total ratio. The ratio can add information when a healthcare provider is evaluating an elevated total PSA.
Order Prostate-Specific Antigen (PSA), Free-to-Total Ratio
Order online and visit a local collection site, or choose an at-home kit where available. No referral and no insurance required.
Order Prostate-Specific Antigen (PSA), Free-to-Total Ratio- Typical turnaround
- 1-3 business days
- Starting price
- From $178
- Results
- Confidential, online
Quick answer
The Prostate-Specific Antigen Free-to-Total Ratio Test measures three related values from a blood sample: total PSA, free PSA, and the ratio of free to total PSA. PSA is a protein produced by the prostate gland, and the ratio can provide additional information when the total PSA is elevated. The test is used by healthcare providers as part of prostate evaluation and is interpreted with other findings such as examination results and the person's history.
What this test measures
Prostate-specific antigen is a protein made by prostate cells, and small amounts are normally present in the blood. Total PSA measures everything detected by the assay, while free PSA measures the portion that is not bound to other proteins. The free-to-total ratio is calculated from those two values and can help characterize an elevated total PSA when a healthcare provider is deciding what evaluation steps may be appropriate.
The test requires only a blood sample, and results are reported as quantitative PSA concentrations along with the calculated percentage of free PSA. Some laboratories also report complexed PSA or age-specific reference ranges. Because PSA can be affected by benign prostate enlargement, inflammation, recent procedures, and other factors, results are never interpreted in isolation.
This test may be ordered after an elevated total PSA result or when a healthcare provider wants more detail during prostate evaluation. It is not a cancer test by itself and cannot confirm or exclude prostate cancer. A qualified healthcare provider should interpret the results and determine whether additional evaluation is needed.
- Total prostate-specific antigen (PSA)
- Free PSA
- Percent free PSA (free-to-total ratio)
- Complexed PSA when reported by the laboratory
- Age-specific PSA reference ranges when provided
- Assay method and calibration information as reported
Why people order this test
- Add detail when a total PSA result is elevated
- Support a healthcare provider's prostate evaluation
- Compare free and total PSA fractions from a single sample
- Follow changes in PSA over time when serial testing is ordered
- Provide information for a discussion about further evaluation options
How to prepare
No fasting is required for this test. A blood sample is collected at the lab. Because some activities and procedures can affect PSA levels, tell your healthcare provider about recent examinations, procedures, or other relevant events before the draw.
Understanding your results
Results are typically available within one to three business days. The free-to-total ratio is used together with the total PSA value and other clinical information; it does not diagnose cancer on its own. A qualified healthcare provider should interpret the results.
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Frequently Asked Questions
What is free PSA?
Free PSA is the portion of prostate-specific antigen in the blood that is not bound to other proteins. It is measured alongside total PSA to calculate the free-to-total ratio.
Why is the free-to-total ratio used?
The ratio can add information when the total PSA is elevated, helping a healthcare provider assess the situation. It is interpreted with other findings, not alone.
Can this test tell me whether I have prostate cancer?
No. PSA testing provides information that a healthcare provider uses during evaluation. Diagnosing or excluding prostate cancer requires additional assessment.
What can raise PSA levels?
Benign prostate enlargement, prostate inflammation, recent procedures or examinations, and other factors can affect PSA. Share relevant details with your healthcare provider before testing.
How is the sample collected?
A small blood sample is drawn from a vein, usually in the arm, during a short lab visit.
Ready to get tested?
Order online and visit a collection site near you, or choose a mail-in kit. No referral and no insurance required.
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