BACKGROUND: The Prostate Health Index (phi) outperforms PSA and other PSA derivatives for the diagnosis of @entity263 ( @entity263 ). The impact of phi testing in the real-world clinical setting has not been previously assessed. METHODS: In a single, large, @entity4207 center, phi was tested in 345 @entity1 presenting for diagnostic evaluation for @entity263 . Findings on prostate biopsy (including Grade Group (GG), defined as GG1: Gleason score (GS) 6, GG2: GS 3+4=7, GG3: GS 4+3=7, GG4: GS 8 and GG5: GS 9-10), magnetic resonance imaging (MRI) and radical prostatectomy (RP) were prospectively recorded. Biopsy rates and outcomes were compared with a contemporary cohort that did not undergo phi testing (n=1318). RESULTS: Overall, 39% of @entity1 with phi testing underwent prostate biopsy. No @entity1 with phi<19.6 were diagnosed with @entity263 , and only three @entity1 with phi<27 had @entity5 of GG   2. Phi was superior to PSA for the prediction of any @entity263 (area under the receiver operating characteristic curve (AUC) 0.72 vs 0.47) and GG   2 @entity263 (AUC 0.77 vs 0.53) on prostate biopsy. Among @entity1 undergoing MRI and phi, no @entity1 with phi<27 and PI-RADS   3 had GG   2 @entity5 . For those @entity1 proceeding to RP, increasing phi was associated with higher pathologic GG (P=0.002) and stage (P=0.001). Compared with @entity1 who did not undergo phi testing, the use of phi was associated with a 9% reduction in the rate of prostate biopsy (39% vs 48%; P<0.001). Importantly, the reduction in biopsy among the phi population was secondary to decreased incidence of negative (8%) and GG1 (1%) biopsies, whereas the proportion of biopsies detecting GG   2 @entity5 remained unchanged. CONCLUSIONS: In this large, real-time clinical experience, phi outperformed PSA alone, was associated with high-grade @entity263 , and provided complementary information to MRI. Incorporation of phi into clinical practice reduced the rate of unnecessary biopsies without changing the frequency of detection of higher-grade @entity5 . @entity263 and @entity4623 advance online publication, 24 January 2017; doi:10.1038/pcan.2016.72.

Use of the Prostate Health Index for detection of @entity263 : results from a large XXXX practice.

@entity1 :: ('9606', 'Species') :: ['patients', 'men'] @entity263 :: ('MESH:D011471', 'Disease') :: ['Prostate Cancer', 'prostate cancer', 'PCa'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancers', 'cancer'] @entity4207 :: ('MESH:D007859', 'Disease') :: ['academic'] @entity4623 :: ('MESH:D011469', 'Disease') :: ['Prostatic Diseases']
@entity4207 :: (MESH:D007859,Disease) :: ['academic']
