Prostate Health Index Use May Avoid Unnecessary Biopsies in Black Men

Prostate Health Index (PHI) demonstrates moderate accuracy in detecting Gleason grade group (GG) 2-5 prostate cancer (PCa) in Black men, according to a study published in the Journal of Urology.

To conduct this study, researchers enlisted 158 biopsy-naïve Black men who were biopsied for elevated prostate-specific antigen (PSA), as well as 135 cancer-free Black men (control group). Subsequently, descriptive analysis was used to compare PCa cases and controls to the frequency of GG2-5 PCa across PHI scores. The researchers noted that receiver operating characteristics compared the discrimination of PSA, PHI, and other PSA-related biomarkers.

According to the results, about 33% of biopsied patients had GG2-5 PCa. The researchers observed that among Black men with a PSA from 4.0 to 10.0 ng/mL, PHI and PSA had similar levels of GG2-5 PCa (0.63 vs. 0.57; P=0.27). Moreover, the investigators noted that in Black men with PSA ≤10.0, a threshold of PSA ≥4.0 had 90.4% sensitivity for GG2-5 PCa; a threshold of PSA ≥4.0 with PHI ≥35.0 in series avoided unnecessary biopsy in 33.0% of men but missed 17.3% of GG2-5 PCa.

“PHI has moderate accuracy in detecting GG2-5 PCa in Blacks, but PHI ≥28.0 can be safely used to avoid some unnecessary biopsies in Blacks,” the researchers concluded.