Blood test results for PSA Free and PSA Prescent Free

Above 25% is considered good. You really are on the border

Between 10% and 25%: Borderline. Your doctor will evaluate this range alongside other factors like age, prostate size, and family history.

Free PSA numbers cannot be read in a vacuum; they must be interpreted alongside your total PSA, age, and any physical exam (DRE) findings

It would be helpful to have your context of PSA also and the history if your PSA that led to your Urologist wanting you to get your free PSA

My PSA was only 5.1, but had risen almost 2 ng.ml in 15 months, nothing felt on DRE. Free PSA was .969 ng/ml and only 19%. MRI ordered which showed lesion, and biopsy with 4+4=8 with cribriform and IDC. In my case, rising PSA, although still relatively low, plus low free PSA prompted MRI, which prompted biopsy which confirmed high risk aggressive PCa. Free PSA is an important tool in your urologist's toolbox, as @jeffmarc said, a number of other factors need to be considered. 23% is just below normal and the 23% and .916 ng/ml tells me your total PSA is still fairly low. So either your urologist felt something on your DRE or your PSA has risen more than .75 in the past year and is above 4.0. It could also be low because of some temporary inflammation.

Blood tests are part of the pool of information.

MRI and ultimately Biopsy will provide the information needed.

Best Wishes.

Had to look up free PSA test, so call national center of excellence skipped that and went to MRI after PSA around 5.2 and small amount of blood in semen. Interesting seeing test that maybe should have been performed on me that were not, but maybe for the best as got to finding the cancer quicker? Also, often wondered why they never did a PSE test.

The free PSA results with a rising PSA can move you to the MRI and possible biopsy, which in your case it sounds they were concerned enough with your PSA and blood went straight to the MRI. The PSE test is helpful along with the ExoDX to help in deciding whether you want to pursue a biopsy after a non finding MRI and current PSA results or wait for retesting PSA and monitoring them. They can also be an encouragement to your physician to order something he might otherwise wait on. If you went straight from MRI to Biopsy likely based on MRI findings and at that point those tests would not be necessary.