A high free PSA to total PSA ratio is not a problem, a low ratio requires vigilance! This needs to be based on the specific ratio, and its total PSA level to further determine: 1, if the total PSA belongs to the normal range, the ratio of free PSA to total PSA is low can be regularly observed clinically, and there is no clear practical significance, temporarily do not consider the existence of prostate malignant tumors. 2, if the total PSA>4ng/L, <10ng/L, the ratio of free PSA to total PSA is low. It is recommended to consult a doctor in time, and prostate puncture biopsy is needed if necessary.3. If the total PSA level is >10ng/L or more, no matter the ratio of free PSA to total PSA is high or low, it is necessary to be alert to the possibility of prostate tumor, and it is recommended to carry out prostate puncture biopsy, to rule out the existence of prostate malignant tumors. Therefore, this ratio needs to be combined with the total PSA level for further judgment.