Prostate cancer risk calculators can help you avoid premature biopsy, treatment & side effects.
A premature biopsy occurs before you are ready based on your risk tradeoffs when they are informed by full use of new screening technology and effective prostate cancer risk calculators.
Triggered by elevated PSA, premature biopsy, possible diagnosis and treatment can lead to:
Learn more about Prostate Smart Screening for Cancer at our home page in a new window.
Use Prostate Cancer Risk Calculator Technology that Is Free on the Internet
Two prominent prostate cancer risk calculators to assess elevated PSA are available at no charge on the Internet:
For your elevated or high PSA, we encourage you to consider using the European Randomized Study of Screening for Prostate Cancer Risk Calculator (ERSPC-RC) and possibly the Prostate Cancer Prevention Trial Risk Calculator (PCPT-RC) to help you and your physicians assess your prostate cancer risks. Both risk calculators consider may variables and screen significantly more effectively than PSA alone.
Example Prostate Cancer Risk Analysis for Elevated and High PSA
Your prostate cancer risk can range from very low to very high depending on your information considered by the risk calculators. Learn about the wide variation in risk calculator and 4Kscore results for an elevated PSA and a high PSA on two pages that open in new windows:
For example, here is the powerful effect of your prostate volume on the risk of significant (but often far from deadly) prostate cancer for PSA 3.0 and PSA 6.0 for the ERSPC Risk Calculator:
Use the ERSPC-RC with Prostate Volume and PHI if Possible for Max Effectiveness
A 2016 British Journal of Urology International multi-institutional Irish study shows that the ERSPC-RC significantly outperforms the PCPT-RC in the prediction of prostate cancer (PubMed abstract in a new window). A 2012 World Journal of Urology very large European and US multi-institutional study shows the importance of prostate volume in the ERSPC-RC for screening effectiveness (PubMed abstract in a new window).
The improvement using prostate volume appears to account for the difference in performance between the ERSPC-RC and PCPT-RC, which does not consider prostate volume. ERSPC-RC results for elevated PSA and high PSA show the very large influence of prostate volume on significant cancer risk. Learn about Prostate Ultrasound measurement of prostate volume in a new window.
The 2016 British Journal of Urology International study, above, also shows the additional significant improvement in the ERSPC-RC when the Prostate Health Index (PHI) is considered. PHI uses three blood tests, including PSA and Free PSA. Learn more about Prostate Health Index (PHI) and its use of Free PSA in new windows.
For these reasons, we suggest using the ERSPC-RC with prostate volume and PHI if possible and supplementing it with results from the PCPT-RC if you are African American. Only the PCPT-RC estimates risks for African American men, who have substantially higher risks than other men.
What Is the Probability of Significant Cancer for PHI and Prostate Volume?
For most men, the ERSPC Risk Calculator is critical for effective risk assessment and avoiding a premature biopsy. There are dramatic differences in risk for the same PSA level.
Notice that the probabilities are much higher for a small prostate (the top red curve) than for a large prostate (the bottom blue curve). The probability of cancer is lower for large prostates because they tend to produce more PSA that "explains" elevated levels of PSA.
The dramatic difference in risk for small and large prostates demonstrates why it is so important to consider prostate volume for elevated PSA levels. The risk level of 10% is the same at 8 PHI for a small prostate as at 31 PHI for a large prostate. Full interpretation of PHI depends on prostate volume.
Ask your physician to estimate your prostate volume by digital rectal exam (DRE). Ask for a transrectal ultrasound (TRUS) to measure your prostate volume more accurately before considering a biopsy. To learn more see our Ultrasound-Based Prostate Cancer Smart Screening Analysis page in a new window.
4Kscore Acts Like a Risk Calculator Combined with Blood Tests
To improve on PSA screening for prostate cancer, OPKO Health, Inc. provides 4Kscore as a Laboratory Developed Test (LDT) through its BioReference Laboratories and GenPath Diagnostics:
Learn more about 4Kscore in a new window.
Tom Neville, PhD, is a prostate cancer survivor with a mission to help men make better decisions. He is a Rhodes Scholar from Yale, Phi Beta Kappa, with a Stanford PhD who has worked with leading prostate cancer researchers.