A psa 6.9 is biopsy needed?

Probably: An elevated psa (prostate specific antigen) test may require a prostate biopsy if no other cause for the elevation is determined. Usually, this means ruling out a prostate infection, or prostatitis.

Maybe: While a psa level of 6.9 might suggest the need for a biopsy, factors such as a patients age, other medical conditions, life expectancy, previous psa values, the presence of lower urinary tract symptoms that might suggest prostate infection or inflammation, feel of the prostate on palpation, family history of prostate cancer and patient desire to have the biopsy all factor into this decision.

Elevated psa: Current guidelines would say yes ! unless you have less than a 10 year life expectancy for other reasons...If you don't have that life expectancy don't check psa.

Here are some ... : PSA value alone would not dictate the need for biopsy. Instead, considering its pace of change (?>0.75 ng/ml/yr), DRE (?uneven consistency, regular surface, local induration), risk factors(?FH of P-Ca, blacks, Agent Orange exposure), prior biopsy with T/F PSA as needed, Hx of UTI as documented, etc. and discussing pros and cons of P-Bx before submitting patients to Bx is a genuine modern practice