Calculators · Urology · Formula

PSA density (PSAD)

Also called PSA density, PSAD

Serum PSA divided by prostate volume, to separate BPH-related PSA rise from likely cancer.

ng/mL
mL

Ellipsoid: length × width × height × 0.52.

Fill 2 more fields to see the result.

Formula and scoring

PSAD = serum PSA (ng/mL) ÷ prostate volume (mL).

Exam and ward pearls

  • Benson 1992 introduced PSAD to sort out the PSA "grey zone" of 4–10 ng/mL.
  • Yusim 2020: the best Youden cut-off for any prostate cancer was a PSAD of 0.15.

When not to rely on it

  • No single cut-off is universal; Catalona used 0.078 to keep sensitivity at 95% in the 4–10 ng/mL range, at the cost of more biopsies.
  • Prostate volume estimates vary between TRUS and MRI and between observers.

Source

  1. Benson MC, Whang IS, Pantuck A, et al. Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer. J Urol. 1992;147(3 Pt 2):815-6. doi:10.1016/s0022-5347(17)37393-7 · PMID 1371554
  2. Benson MC, Whang IS, Olsson CA, McMahon DJ, Cooner WH. The use of prostate specific antigen density to enhance the predictive value of intermediate levels of serum prostate specific antigen. J Urol. 1992;147(3 Pt 2):817-21. doi:10.1016/s0022-5347(17)37394-9 · PMID 1371555
  3. Yusim I, Krenawi M, Mazor E, Novack V, Mabjeesh NJ. The use of prostate specific antigen density to predict clinically significant prostate cancer. Sci Rep. 2020;10(1):20015. doi:10.1038/s41598-020-76786-9 · PMID 33203873

Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.

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