‘Superior’ PSA test should be offered: expert

The Prostate Health Index (phi) has been available in Australia since last September but costs $90 and is not Medicare rebatable.

It is an assay for truncated proPSA, which is present as a higher proportion of the free PSA fraction in prostate cancer patients. Specificity for cancer detection rises to 75% with the phi test — a combination of proPSA, free PSA and total PSA — from 55% with the traditional total PSA test alone, the Prostate Cancer World Conference was told.

New York University urologist Dr Stacy Loeb presented data in Melbourne showing that among 658 men being considered for a biopsy after abnormal total PSA results, one in four had phi results indicating aggressive cancer would not be found.

“The phi test can be used to more accurately confirm or discount the need for biopsy where PSA is elevated,