No, in fact less than 30% of men with a PSA level >4.0 ng/mL will be diagnosed with cancer. Unfortunately, the PSA test cannot differentiate between cancer and non-cancerous conditions like an infection (prostatitis), a urinary tract infection (UTI), an enlarged prostate (benign prostatic hyperplasia), or other non-cancerous conditions. Certain types of vigorous exercise, such as cycling, and sexual intercourse can stimulate the prostate and cause PSA levels to rise so men should abstain from both at least 48 hours prior to a PSA test. Regular use of certain medications including statins, NSAIDs, and thiazide diuretics have been shown to cause a decrease in PSA levels, so men should alert their physicians if taking these medications. Conversely, other medications, such as testosterone, can raise PSA levels. Having a digital rectal exam (DRE) prior to a PSA blood test can also momentarily raise PSA levels, which is why the PSA test should be conducted first.  Because the PSA test is a simple, inexpensive blood test, it's a great first step in identifying men who may benefit from additional testing including prostate cancer biomarkers, which can provide more insights about what is causing elevated PSA levels.