Blood is drawn from a vein, usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and an elastic band or blood pressure cuff is placed around the upper arm. This causes veins below the band to swell with blood.

A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the band is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

This test is no longer used routinely. The availability of the more sensitive and specific PSA assay has largely replaced the PAP test's clinical use.

Normal values vary from laboratory to laboratory. Please contact your laboratory or consult your health care provider for normal values.

Abnormal PAP values can be obtained for many reasons. The most common reasons for abnormal PAP values include, but are not limited to:

• Prostate cancer
• Prostate cancer that has spread outside the prostate (particularly to bone)
• Decreased blood flow to prostate
• Paget's disease (bones become thicker and softer)
• Anemia
• Infection (usually severe)
• Thrombophlebitis
• Gaucher's disease
• Hyperparathyroidism
• Heart attack
• Kidney disease
• Physical stimulation of the prostate (colonoscopy, enemas, prostate examination)
• Multiple myeloma
• Prostatitis

• Excessive bleeding
• Fainting or feeling lightheaded
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)
• Multiple punctures to locate veins

Prostate cancer that is located only in the prostate gland may not produce high enough levels to indicate a problem. If your PAP test is normal it does not eliminate the possibility that you have prostate cancer.

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.