The prostate health index (PHI) is a blood test that more accurately assesses the risk of prostate cancer than a traditional PSA test. The PHI combines three different PSA tests to create one risk score. It may reduce the need for biopsies in people who are at lower risk for cancer.
A PHI test uses three different forms of the prostate-specific antigen (PSA), a protein your prostate makes that can become elevated if you have conditions like an enlarged prostate, prostate infection, or prostate cancer. These three forms include:
- Total PSA: The total level of PSA in your blood
- Free PSA: The portion of PSA that is not attached to proteins in your blood
- p2PSA: A variation of PSA that may be specific to prostate cancer
The PHI combines the measurements in a formula to produce one score. It gives a more accurate representation of prostate cancer risk compared to the traditional total PSA test.
The PHI test produces a single score ranging from 0-55+ that can reveal information about your prostate cancer risk. Higher scores and lower scores may both reveal different information.
A higher score (above 35) indicates a higher chance of prostate cancer that needs treatment. The test is not diagnostic, though—a prostate biopsy is necessary for a definitive diagnosis. If you have a slightly high score, your healthcare providers may also look into your other prostate cancer risk factors before determining the next steps.
A lower score (under 35) suggests a lower risk of prostate cancer that requires treatment. If you have a lower PHI score, healthcare providers may choose to monitor you over time rather than recommending a biopsy.
The prostate health index provides several benefits over the traditional total PSA test. These include:
- Accuracy: The total PSA test can’t differentiate among the potential causes of an increased PSA level. The PHI’s combination of three variations of PSA makes it more specific in detecting prostate cancer.
- Reduced biopsies: Because it’s more specific, PHI tests reduce the need for unnecessary prostate biopsies, sparing the potential costs, discomfort, and other complications of a biopsy.
- Early cancer detection: Prostate cancer may not cause symptoms until it has reached an advanced stage. PIH is useful in the early detection of prostate cancer, especially cases that require treatment.
It’s important for people who are at a higher risk of prostate cancer to consider getting the PHI test. Talk to a healthcare provider about your risk, which may be higher if you:
- Have a family history of prostate cancer
- Are 50 years or older
- Are Black
- Have known genetic mutations of the genes BRCA1 or BRCA2
Also, men with slightly higher PSA levels of 4-10—sometimes called a diagnostic gray zone—can undergo the test to confirm whether their PSA levels are likely higher due to cancer or another prostate condition.
The prostate health index is a simple blood test. A healthcare provider may ask you to sit comfortably in a chair. In some cases, they may also ask you to lie down. Then, you can expect the blood drawing process to involve these steps:
- The healthcare provider cleans the area with an antiseptic (germ-killing) solution.
- They put an elastic band on your upper arm to help the area swell with blood.
- They insert a needle into a vein in your arm to collect blood in an airtight vial or tube attached to the needle.
- They remove the needle and band from your arm and apply a cotton pad or bandage to the needle site.
The test usually takes place at a diagnostic laboratory or your healthcare provider’s clinic. The cost of the test varies, but usually ranges between $35-$370. You can talk to your health insurance provider, if you have one, to help determine whether they’ll cover the cost of the test.
The prostate health index (PHI) is a blood test for prostate cancer screening. By combining measures of three different variations of prostate-specific antigen (PSA), it offers better accuracy, reduces the need for unnecessary biopsies, and can help in the early detection of prostate cancer that needs treatment.
