Prostate Cancer Risk Calculator
Use this prostate cancer risk calculator to estimate your chance of no cancer, low-grade or high-grade cancer on a biopsy, from your PSA and risk factors.
Updated October 22, 2026
Medical Disclaimer: This calculator gives a general estimate for education only and cannot diagnose a condition. Share your result with your doctor or the clinician who ordered your test, and do not start, stop or change any medicine based on it. Read our full Medical Disclaimer.
How Prostate Cancer Risk Is Calculated
Prostate cancer risk, here, is the chance that a prostate biopsy done now would find cancer. This calculator uses the Prostate Cancer Prevention Trial Risk Calculator 2.0 (PCPTRC 2.0), a model built from thousands of biopsies in a large US trial¹. It turns your PSA result and a few facts about you into three percentages that add up to 100.
What the PCPT Risk Calculator Measures
It estimates what a biopsy would show today, split into three outcomes: no cancer, low-grade cancer (Gleason score 6 or lower) and high-grade cancer (Gleason 7 or higher)¹. It does not measure lifetime risk, and it cannot tell you whether you have cancer.
The Formula
PCPTRC 2.0 is a multinomial logistic model, which means it compares each cancer outcome with "no cancer" at the same time¹:
S1 (low-grade) = -3.002 + 0.256 x log2(PSA) + 0.016 x Age + 0.122 x Black + 0.272 x Family history - 0.455 x Prior negative biopsy - 0.039 x Abnormal DRE
S2 (high-grade) = -7.053 + 0.705 x log2(PSA) + 0.048 x Age + 1.042 x Black + 0.225 x Family history - 0.214 x Prior negative biopsy + 0.401 x Abnormal DRE
Chance of no cancer = 1 / (1 + e^S1 + e^S2)
Chance of low-grade cancer = e^S1 / (1 + e^S1 + e^S2)
Chance of high-grade cancer = 100% minus the other two
Each yes/no factor counts as 1 for yes and 0 for no. The model was published by Ankerst and colleagues in 2014, and the version on riskcalc.org from Cleveland Clinic is the official reference tool¹ ².
How This Calculator Computes Your Result
Enter your age (55 to 90), PSA in ng/mL (the same number in µg/L), race or ethnicity, whether your father, brother or son has had prostate cancer, your digital rectal exam (DRE) result and any prior biopsy. An optional percent free PSA result updates the estimate, as in the published model¹. We use the full-precision official coefficients and round to whole percents. "Don't know" for family history and "Not done" for DRE count as no, as on the official tool². If you are unsure about a past biopsy, we use the model version without that question. You also see a 100-person picture and which answers moved your estimate.
What Your Result Means
Your result shows how 100 men like you would be expected to split if each had a biopsy. There is no cut-off that says a biopsy is needed; the developers state that this is an individual choice made with a doctor². This table shows how PSA changes the estimate for a 60-year-old man with no family history, a normal DRE and no past biopsy (no cancer / low-grade / high-grade):
PSA (ng/mL) | Not Black | Black |
1 | 87% / 12% / 1% | 84% / 13% / 3% |
2 | 83% / 14% / 3% | 78% / 15% / 7% |
4 | 78% / 17% / 5% | 70% / 18% / 12% |
6 | 74% / 19% / 7% | 64% / 19% / 17% |
10 | 68% / 21% / 11% | 56% / 20% / 24% |
As PSA rises, the high-grade share grows faster than the low-grade share. Black race mainly raises the high-grade figure. An abnormal DRE also raises it, while a past negative biopsy lowers the estimate¹.
PSA Basics
PSA (prostate-specific antigen) is a protein made by normal and cancerous prostate cells, and the test measures how much of it is in your blood³. There is no single PSA level that separates normal from abnormal³. PSA rises with age and with a larger prostate (benign prostatic hyperplasia) or prostatitis, and it can go up for a short time after an infection, a biopsy, ejaculation or vigorous cycling³. Finasteride and dutasteride, used for an enlarged prostate, lower PSA³, and this calculator does not adjust for them.
A "normal" PSA does not rule cancer out. In the trial this model came from, 2,950 men whose PSA never went above 4.0 ng/mL and whose rectal exams stayed normal had a biopsy after seven years, and 15.2% of them had prostate cancer⁴. That ranged from 6.6% of men with PSA of 0.5 or less to 26.9% of men with PSA of 3.1 to 4.0⁴. This is why the calculator treats PSA as a sliding scale rather than a pass or fail.
If You Do Not Have a PSA Result
This calculator needs a PSA number, so without one it shows context for your age instead. The US Preventive Services Task Force (USPSTF) says that for men aged 55 to 69, having a PSA test is an individual decision made after talking with a clinician about benefits and harms⁵. For men 70 and older, it recommends against PSA-based screening⁵. This 2018 recommendation is still the current one in October 2026, and the USPSTF lists it as being updated⁵.
Three factors raise baseline risk. Prostate cancer is rare before 40, and about 6 in 10 cases are found in men over 65⁶. It is more common in Black men⁶. A father or brother with prostate cancer more than doubles a man's risk, and several affected relatives raise it further⁶. The USPSTF advises clinicians to tell Black men and men with a family history about their higher risk, so they can make an informed choice about testing⁵.
Expected Biopsy Results by PSA Level
How 100 men like the example would split if each had a biopsy. Switch race to compare.
- No cancer
- Low-grade cancer
- High-grade cancer
Show data table
| PSA | No cancer | Low-grade cancer | High-grade cancer |
|---|---|---|---|
| PSA 1 ng/mL | 87% | 12% | 1% |
| PSA 2 ng/mL | 83% | 14% | 3% |
| PSA 4 ng/mL | 78% | 17% | 5% |
| PSA 6 ng/mL | 74% | 19% | 7% |
| PSA 10 ng/mL | 68% | 21% | 11% |
A Note on Accuracy
PCPTRC 2.0 was built on 6,664 biopsies from 5,826 men in the placebo group of a US prevention trial, most of them White, who had yearly PSA tests and rectal exams². About 80% had six-core biopsies, and modern biopsies often take more samples or follow an MRI, which can find more cancer than the model predicts². Its developers have since built a newer model, the PBCG calculator, from 16,369 biopsies done in 2006 to 2017, and say it should replace this one for men who have been referred for a biopsy⁷. It was tested in 10 outside groups of men plus a national reference set and held up well, but accuracy varies between populations¹. The model has a separate factor only for Black race, so Hispanic, Asian and other men get the same estimate as White men. Use a PSA and DRE result less than a year old². This is an estimate, not a diagnosis.
Frequently Asked Questions
What is a normal PSA level?
There is no single normal PSA level, and a reading above 4.0 ng/mL is often treated as a reason for further tests³. Cancer is still found in some men below 4.0, so PSA is best read as a sliding scale of risk⁴.
How accurate is the prostate cancer risk calculator?
PCPTRC 2.0 held up well when tested in 10 outside groups of men, but it can differ from your real risk, especially if you are not White or your biopsy would use MRI or more cores¹ ². It estimates a chance, not a diagnosis.
Can you have prostate cancer with a low PSA?
Yes. In the Prostate Cancer Prevention Trial, 15.2% of men whose PSA never rose above 4.0 ng/mL and whose rectal exams stayed normal had cancer on biopsy, and some of those cancers were high grade⁴.
At what age should men get a PSA test?
The USPSTF says men aged 55 to 69 should decide for themselves after talking with a clinician, and it recommends against routine PSA screening from age 70⁵. It makes no separate rule for Black men or men with a family history, but asks clinicians to tell them about their higher risk⁵. The American Urological Association advises offering screening from 40 to 45 for Black men, men with a strong family history and men with an inherited gene change⁸.
Sources
Prostate Cancer Prevention Trial Risk Calculator 2.0, Ankerst et al., 2014
PCPTRC 2.0 Risk Calculator, Cleveland Clinic
Prostate-Specific Antigen (PSA) Test, National Cancer Institute
Prevalence of Prostate Cancer among Men with a PSA Level of 4.0 or Less, Thompson et al., 2004
Prostate Cancer: Screening, US Preventive Services Task Force, 2018
Prostate Cancer Causes, Risk Factors, and Prevention, American Cancer Society
A Contemporary Prostate Biopsy Risk Calculator Based on Multiple Heterogeneous Cohorts, Ankerst et al., 2018
Early Detection of Prostate Cancer: AUA/SUO Guideline, American Urological Association, 2026