Understanding the Prostate Health Index (PHI)
Evidence on how composite biomarkers may improve risk stratification in prostate cancer assessment.
Background
Traditional screening approaches such as prostate-specific antigen (PSA) testing can lead to over-diagnosis. The Prostate Health Index (PHI) combines total PSA, free PSA, and [-2] proPSA to provide additional context on cancer risk.
Key Findings
Distinguishing Aggressive Disease
A recent meta-analysis reported that PHI demonstrated improved discrimination between clinically significant and indolent prostate cancer compared with PSA alone, potentially reducing unnecessary biopsies.
Clinical Considerations
Authors note that PHI may be most informative when combined with other clinical factors. Integration into practice varies by region, and standardized thresholds continue to be evaluated.
What This Means & Limitations
Biomarkers like PHI could aid shared decision-making by identifying individuals who may benefit from further diagnostic workup. Availability, cost, and clinician familiarity can influence access. Evidence is still evolving, and PHI should complement—not replace— broader clinical assessments.