PHI as a Better Prognostic Test for African-American Men
Researchers at Johns Hopkins assessed PHI values in 80 African- American patients with PSA values of 2-10 ng/ml prior to their radical prostatectomies. Twenty percent of the men had pathological stage 3 (pT3) prostate cancers. Although age, PSA and percentage-free PSA were similar among all the men, PHI values were significantly greater in the patients with stage 3 disease. Also, a PHI value greater than 50 was associated with increased odds of non-organ-confined cancer.
PHI is a simple blood test that is nearly 3 times more accurate in detecting prostate cancer than the free/total PSA test. Dr. Catalona led the national study that led to the approval of PHI by the U.S. Food and Drug Administration.
Adding PHI to a baseline model that included digital rectal exams (but not Gleason score or percentage of positive biopsy cores) improved the model’s diagnostic accuracy by 12.9% compared to models with other individual biomarkers, such as PSA.
African-American men tend to have more aggressive prostate cancer than Caucasian men. Although the cohort in this study is small, the findings mirror previous findings in the overall population.