According to the American Cancer Society, there will be roughly 160,000 new cases of prostate cancer diagnosed in the US this year alone, with over 26,000 deaths estimated from this disease.  It is essential that aggressive forms of prostate cancer, that are more likely to spread and lead to death, are diagnosed early when they may still be treatable. Traditionally this has been done through screening with PSA, followed by a prostate biopsy for men with an abnormal result. Unfortunately, in many cases PSA is elevated in men without prostate cancer. As a result, there are many unnecessary prostate biopsies, which has led to a push to reduce or eliminate prostate cancer screening.
The PSA Dilemma
The PSA test is a widely used blood screening test for prostate cancer, that measures the amount of prostate-specific antigen (PSA). During the time since its widespread adoption, there has been a significant reduction in metastasis and death due to prostate cancer. However, most men getting a prostate biopsy after screening with PSA will not have aggressive prostate cancer, and many will not have any cancer at all. Due to the complications associated with prostate biopsy, including hospitalization, bleeding, sepsis, and pain, it is important to reduce the number of unnecessary biopsies done. [2, 3, 4] There is a clear need to both continue to find men with a higher risk for aggressive prostate cancer early, and reduce biopsies in men with a low risk.
The True Cost of Unnecessary Prostate Biopsy
Unnecessary prostate biopsies include a range of medical expenses due to procedural and diagnostic costs, but the true cost reaches beyond that. Patients and their families experience anxiety around the side effects of prostate biopsies, as well as the fear of the detection of cancer. The harms from over-diagnosis and over-treatment of benign conditions and indolent prostate cancer can be very significant.
4Kscore & the Prostate Biopsy Decision
The 4Kscore Test is a simple blood test, used after an abnormal PSA, that reduces unnecessary prostate biopsies by providing the risk of aggressive prostate cancer before a biopsy decision is made. It measures four prostate-specific proteins in the blood: Total PSA, Free PSA, Intact PSA, and Human Kallikrein 2 (hK2), and combines them with clinical findings (age, prior biopsy history, and optionally a digital rectal examination) to provide a risk score. By asking for a 4Kscore test, men and their physicians can make a biopsy decision knowing the personal risk for aggressive prostate cancer, and avoid unnecessary procedures in low risk men.
At BioReference, we are committed to helping reduce the number of unnecessary biopsies performed annually, while helping men at high risk get the proper evaluation they need. If you, or a loved one, have recently received news of an abnormal PSA score, we encourage you to speak to your doctor about undergoing a 4Kscore Test. If you are a physician interested in offering the 4Kscore Test in your practice, we encourage you to contact us today. Learn more about how this simple blood test is helping to reduce unnecessary biopsies.
- American Cancer Society. Key Statistics for Prostate Cancer. (Access June 12, 2017) https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html
- National Cancer Institute. Prostate-Specific Antigen (PSA) Test. (Access June 12, 2017) https://www.cancer.gov/types/prostate/psa-fact-sheet
- Parekh DJ, Punnen Sm, Sjoberg DDm et al. A Multi-institutional Prospective Trial in the USA Confirms that the 4Kscore Accurately Identifies Men with High-grade Prostate Cancer. Eur Urol. 2015; 68:464-70.
- Liss, M. A., et al. (2017). “An Update of the American Urological Association White Paper on the Prevention and Treatment of the More Common Complications Related to Prostate Biopsy.” J Urol.