PSA circulates in two main forms: free (unbound) and complexed to proteins. Prostate cancer tends to produce more complexed PSA, so a lower percent free PSA increases cancer risk, while a higher percent free PSA suggests benign prostate enlargement is more likely.
This test is most useful in patients with total PSA in the borderline range (typically 4-10 ng/mL) where the percent free PSA helps decide whether biopsy is needed. Lower percent free PSA values (typically below 25%) warrant closer evaluation. Sample type is serum.
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