An Inexpensive and Noninvasive Option To Determine the Probability of Prostate Cancer

The Prostate Health Index (phi) is an FDA-approved blood test that aids in distinguishing prostate cancer from benign prostatic conditions.

Elevated prostate-specific antigen (PSA) is used to screen for prostate cancer but is limited in its ability to accurately assess individuals for cancer, especially those with a PSA value between 4 and 10 ng/mL. The phi combines three prostate-specific biomarkers—total PSA, free PSA, and p2PSA—into one overall score to provide an effective estimate of prostate cancer risk before biopsy.

National Comprehensive Cancer Network (NCCN) guidelines1 endorse the phi as an optional secondary biomarker to aid patients and clinicians in decision-making following an elevated PSA.

When Should the Prostate Health Index Be Ordered?

The phi is recommended for males who are older than 50 years, have a PSA value between 4 and 10 ng/mL, and have digital rectal examination (DRE) findings that are not suspicious for cancer.

Benefits of the Prostate Health Index

  • Avoid unnecessary biopsies: The phi distinguishes between those with a low and high risk of prostate cancer and can reduce unnecessary biopsies by up to 30%.2
  • Reduce costs: The phi assay is significantly less expensive than other screening options. By reducing unnecessary biopsies, the phi also decreases the financial burden on patients and health systems.
  • Receive faster results: Results are returned within one to seven days, quickly providing actionable information that can aid in early diagnosis and facilitate care decisions.
  • Access greater accuracy: The inclusion of p2PSA, a PSA isoform closely associated with cancerous tissue, improves the accuracy of the phi assay in distinguishing cancerous from benign conditions.

Additional Resources

ARUP Consult®: Prostate Cancer

References

  1. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: prostate cancer early detection. Version 2.2026. Updated Feb 2026; accessed Apr 2026.
  2. Loeb S, Sanda MG, Broyles DL, et al. The prostate health index selectively identifies clinically significant prostate cancer. J Urol. 2015;193(4):1163-1169.