Elevated PSA with negative biopsy

Alan J. Wein, MD
Last Modified: March 3, 2002


Dear OncoLink "Ask The Experts,"

I have a friend who has repeatedly elevated PSA levels. He also has cirrhosis and is a hepatitis B carrier. His urologist has biopsied his prostate gland annually X 3 or 4 years with tissue reports consistently negative for neoplasia. Will cirrhosis or being hepatitis B carrier cause elevated PSA levels?



Alan J. Wein, MD, Professor and chair of the Division of Urology at the University of Pennsylvania School of Medicine and Chief of Urology at the Hospital of the University of Pennsylvania, responds:

To my knowledge neither cirrhosis nor hepatitis B will cause elevated PSA levels. However, one should remember that there are many causes for increased serum PSA levels besides prostate cancer. Of men with PSA values between 4 and 10, on average only 25-30% will be found to have carcinoma on biopsy. Also, there are many ways to look at PSA determinations: absolute value, change over time, PSA related to prostate size, fractionations of the PSA into total/free PSA, and PSA related to age. Your urologist should be able to provide you with an update of all of these issues.


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