Prostate Health Index Test (PHI) for Prostate Cancer

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.


What is the Prostate Health Index test?

Prostate Health Index (PHI) is a test that predicts the risk of having prostate cancer. It is used instead of the PSA test for prostate cancer detection and prostate cancer screening. PHI provides more useful information than PSA alone and is more specific for prostate cancer.  When the Prostate Health Index test is elevated, there is a greater likelihood of having prostate cancer than when a PSA test is elevated.

What are the Advantages of Prostate Health Index Test?

PHI for Prostate CancerBecause PHI has a better predictive ability, it has been recommended by the NCCN as a test to be used in men at risk for prostate cancer. the Prostate Health Index (PHI) test is superior to total PSA, as well as free PSA to total PSA ratio when it comes to predicting the risk of having prostate cancer in men with PSA level under 10.

The PHI test is also superior to the PCA3 test in predicting whether a man has prostate cancer.

The PHI test can be used to choose men who need a prostate biopsy.  The Prostate Health Index test can also be used to choose men who are unlikely to have prostate cancer and thus can avoid a biopsy.

What is the PHI test?

The PHI or Prostate Health Index test is a blood test that is used to predict the risk of having prostate cancer in men. The PHI test is used instead of the traditional PSA test.  The Prostate Health Index test is actually derived from the PSA test.  The PHI test is a combination of the free PSA, total PSA, and the [-2]proPSA isoform of free PSA.   These 3 tests are mathematically combined in a formula that results in a Prostate Health Index or PHI score. The PHI score is a better predictor of prostate cancer than the total PSA test alone or the free PSA test alone.  The Prostate Health Index is also a better predictor of prostate cancer risk than the free PSA to total PSA ratio or the free PSA ratio.

The PHI test offers better sensitivity as well as better sensitivity for prostate cancer.  This means that men with a low score are less likely to have prostate cancer and those with a higher score are much more likely to have prostate cancer.

When is the PHI Prostate Cancer test recommended?

The PHI test for prostate cancer detection is advised for any men who previously had a reason to have a PSA test or who have had a PSA test in the past.  Men with hematuria, slow urine stream, and other urinary problems are advised to have a test for prostate cancer such as PHI test.

Men with slightly elevated PSA can use tests such as the PHI and 4Kscore test to decide whether they should have a prostate biopsy.  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 other Test are 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 are now available.

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), both of which incorporate the traditional PSA test as well. Thus, the report will list both the traditional PSA test and the 4KScore or PHI score respectively.

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 differences between PHI and 4KScore tests.


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