The trend is important as well as the slope of the PSA result line. I have had BPH for over 15 years (Im 75), with a slowly rising PSA, but never over 4. That is, until it popped to 6.5. Then I was referred to a urologist, MRI, biopsy and PCa diagnosis. Symptoms never really progressed, it was the abrupt change in PSA that made the difference.