prostate health index: a look into the newest blood test
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Prostate Health Index: A look Into the Newest Blood Test
TheProstateHealthIndex(phi),abloodtestusedtoevaluatetheprobabilityofprostatecancerdiagnosis,outperformedcommonlyusedPSAandfree/totalPSAtestsinpredictingthepresenceofclinicallysignificantprostatecancerandinimprovingprostatecancerdetection,accordingtoanewstudy.
PHImayreduceunnecessarybiopsiesThephicombinesmeasurementsof%fPSA(percentofprotein-attachedandprotein-freePSAcirculatinginthebloodstream)andasubcategoryoffreePSAcalledpro-PSA,andisestimatedtobe2.5timesmorespecificindetectingprostatecancerinpatientsthanaPSAscreening.ThephiwasapprovedbytheUSFoodandDrugAdministration(FDA)inJune2012andhasbeenavailablesincelate2012.Thestudyalsofoundusingaspecificphibenchmarklevelmayhelpidentifybiopsycandidatesandreduceover-detectionofslow-growingprostatecancer.“ThephicanplayavaluableroleindeterminingwhetheranelevatedPSAislikelyduetoprostatecancerorbenignchanges,”saidBrantThrasher,MD,chairofUrology,UniversityofKansasMedicalCenter,KansasCity,KS.“Thisoptionmaypreventpatientsfrompotentiallyundergoingunnecessarybiopsies.”
Learnmoreat:https://www.auanet.org/advnews/press_releases/article.cfm?articleNo=316
StudyDetailsEmergeResearchersatseveralleadinginstitutionsintheUnitedStatesandtheNetherlands,includingHarvardMedicalSchoolandJohnsHopkinsUniversity,investigatedwhethertheuseofphi,ascomparedtototalPSAand%fPSA,canreduceunnecessarybiopsyandover-detectionofindolentprostatecancer,whileimprovingthedetectionofaggressiveprostatecancer.Thestudyconsistedof658participantswhowere50yearsofageorolderwithabiopsy-confirmedprostatecancerdiagnosis,afinalPSAbetween4-10ng/mLandabenignrectalexamination.Studyinvestigatorsevaluatedpredictionofclinicallysignificantcancerbasedonpre-biopsymeasuresofpro-PSA,totalPSA,fPSA,%fPSAandphiandevaluatedprospectsforeliminatingunnecessarybiopsiesbasedonresultsofphipriortobiopsy.Theresearchersfound:
• At90percentsensitivity,thespecificityofphiwas31.1percent,comparedto19.8percentfor%fPSA(p=0.024)and10.8percentforPSA(p<0.001).
• Atamoderatetohighphirangeof27to55,theprobabilityofcancervariedfrom9.8to50.1percentandtheprobabilityofclinicallysignificantcancerextendedfrom3.9to28.9percent.
• Ataphilevelof27,whichisthe90percentsensitivitycut-point,18.8percentofmencouldhavebeensparedfromundergoingprostatebiopsyorover-diagnosisofnon-aggressivedisease.