Prostate health index (PHI) as an accurate prostate cancer predictor

Purpose This study aims to compare the ability of the PHI versus tPSA test to predict the presence of PCa in our population. Methods A prospective observational study was performed. We included patients with tPSA ≥ 2.5 ng/ml, biopsy naïve or previous negative biopsy, undergoing a blood test, which includes tPSA, fPSA, and p2PSA, and a prostate biopsy between March 2019 and March 2022. Patients with PCa found in the biopsy—Group A—were compared with patients with a negative biopsy result—Group B. Diagnostic accuracy of tPSA and PHI was assessed by receiver operating characteristic [ROC] curves and logistic regression. Results 140 men were included. Fifty-seven (40.7%) had a positive prostate biopsy result (Group A), and 83 (59.3%) had a negative biopsy result (Group B). The mean age was similar in both groups (mean ± standard deviation), 66.86 ± 6.61 years. No difference was found in the tPSA value between the groups (Group A PSA: 6.11 ng/ml (3.56–17.01); Group B: 6.42 ng/ml (2.46–19.45), p = 0.41). The mean value of PHI was statistically different between groups (Group A 65.50 (29–146) vs. Group B 48 (16–233), p = 0.0001). The area under the curve 0.44 for tPSA and 0.77 for PHI. The multivariate logistic regression model applied to PHI showed a significant increase in its predictive accuracy: 72.14% in the model without PHI, 76.09% with PHI. Conclusion The PHI test improves PCa detection compared to tPSA in our population.