4K-Score Test for Men at Risk for Prostate Cancer or Elevated PSA

by Alex Shteynshlyuger MD


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-5515

Dr. Alex Shteynshlyuger is a fellowship-trained urologic oncologist and a robotically-trained surgeon who specializes in all aspects of care for early, advanced and metastatic prostate cancer. He practices at New York Urology Specialists.


What is the 4K Score Test?

The 4KScore test is a blood test that is used to predict the risk of high-risk prostate cancer in men.  This test can be used as a replacement for the traditional PSA test as it provides more information about the risk for aggressive prostate cancer.

When is the 4KScore Prostate Cancer test recommended?

Prostate Cancer 4KScore4KScore test for prostate cancer is advised to men for the same reasons that men were previously advised a PSA test.  Men with symptoms of urinary problems such as blood in urine, frequent urination, slow urine stream, feeling of incomplete bladder emptying, waking up at night to urine are advised to have a test for prostate cancer such as 4KScore test.

Men with slightly elevated PSA can use the 4Kscore test to decide whether they should have a prostate biopsy as 4KScrore better predicts high-risk prostate cancer risk.  Men with a family history of prostate cancer are advised to have screening for prostate cancer.  Other men may choose to screen for early detection of prostate cancer with a 4KScore test.

What Are Other Tests Available for Men at Risk for Prostate Cancer?

While traditionally, the options available to men at risk for prostate cancer were limited to PSA blood test and a prostate exam (DRE, digital rectal exam), a number of exciting, innovative options became available to men, and more exciting innovations are expected in the coming years.

PSA (prostate-specific antigen) is still a useful test but is being supplanted by more informative tests such as 4KScore and PHI (prostate health index).

PHI (prostate health index) is a new test that provides an incremental improvement over the PSA test alone when it comes to predicting the risk of prostate cancer.  It can be used to reduce the need for unnecessary biopsies in some men.

Read more about the differences between PHI and 4KScore tests.

4KScore Test for Prostate Cancer Screening: Early Detection of Prostate Cancer

Prostate CancerScreening for prostate cancer detects prostate cancer early, which allows for timely treatment.  Screening with PSA test has a number of limitations as elevated PSA can occur in the absence of prostate cancer.

Many men undergo biopsy with attended inconvenience, risks, and costs which do not have prostate cancer because with PSA test, there is a degree of uncertainty of who has prostate cancer and who does not.

What we need is a better test for predicting who has prostate cancer.  Then we need to know who among the men with prostate cancer is at risk of having an aggressive disease.  We know that many men with prostate cancer have a very slow-growing disease that may not cause any problems for many years.  Some have a disease that is on fire. We need to tell which is which.

An ideal test would be easy to administer, inexpensive, and will tell us with a great degree of certainty if a man has prostate cancer. Just as important, a good test will also tell us with a great degree of certainty that someone does not have prostate cancer.

4KScore: A Better MouseTrap?

4KScore provides the key to what was missing with the PSA test alone. It allows us to separate men who are at high risk for high-risk, aggressive prostate cancer from those who may never experience symptoms of prostate cancer.

#4KScore is a simple blood test. 4KScore is actually a combination of PSA test with a hK2 (human kallikrein 2) and a few other related tests (free PSA, intact and total PSA, history of prior biopsy, results of DRE (digital rectal exam).

4KScore can be used in combination with PHI to gain a better understanding of the risks associated with prostate cancer.

In our practice, we recommend the 4KScore test to all our patients who are at risk for prostate cancer.  New York Urology Specialists is the first practice in the New York Metro area to offer 4KScore tests to our patients.


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-5515

We see patients from all parts of New York City (Manhattan, Brooklyn, Queens, Bronx, Staten Island), Long Island, Westchester and New Jersey as well as other parts of the USA. We also see international patients from Canada, Japan, South America, Russia, Asia, Europe, Middle East, Africa, the Caribbean and other parts of the world.