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. This is most useful in patients with total PSA in the borderline 4-10 ng/mL range, where percent free PSA helps decide whether biopsy is warranted.
This test is used to refine cancer risk assessment in patients with mildly elevated PSA, helping reduce unnecessary biopsies while identifying patients more likely to have cancer. Sample type is serum.
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