KEY POINT: Prostate Health Index can assist in making a decision about the need for a prostate biopsy.
We know that the prevalence of prostate cancer increases with age. Given this increasing prevalence, an important consideration in the investigation and management of prostate cancer is improving the specificity of detecting clinically significant disease that may require treatment.
PSA screening of the population has been controversial in the detection of prostate cancer, however PSA remains a useful biomarker in the investigation and management of the disease. Improving our detection rate of clinically significant prostate cancer is paramount to improving patient care. The prostate health index (PHI) is a useful blood test to help us. PHI is a formula that combines serum biomarkers of total PSA, free PSA and truncated proPSA.
PHI is most useful where the total PSA result is above the median (2–10 µg/L), it may help determine, with more confidence, whether an elevated PSA is more likely to be associated with prostate cancer, potentially avoiding unnecessary biopsies. We have seen studies replicate that the PHI outperforms all its individual components for the prediction of prostate cancer and specifically, high-grade prostate cancer on biopsies. The PHI also helps in the prediction of the likelihood of progression of men on active surveillance for prostate cancer.
It is important to note however, that unlike PSA testing, PHI does not have a medicare rebate associated with the test.
At the Brisbane Urology Clinic, we offer a world class service for the investigation and management of prostate cancer and are very happy to discuss your questions and accept referrals.
Dr Jonathan Chambers
BSc; MBBS; MPH; FRACS (Urology)
For referral to Dr Chambers please call 07 3830 3380.