The days of using one PSA threshold to trigger a biopsy for all men are over, and the field has moved toward a more individualized approach to prostate biopsy decisions taking into account each patient's specific set of risk factors.
Foley et al. provide compelling evidence supporting the use of the Prostate Health Index (phi) as part of this multivariable approach to prostate biopsy decisions. There is now a large body of evidence showing that phi is more specific for prostate cancer than total PSA and percent free PSA, as was concluded in a 2014 systematic review. This article is protected by copyright. All rights reserved.
BJU Int. 2015 Jun 5. doi: 10.1111/bju.13195. [Epub ahead of print]
Department of Urology, Population Health and Laura & Isaac Perlmutter Cancer Center, New York University and Manhattan Veterans Affairs Medical Center, NY, USA.