New Urine Test Helps Decide Need for Prostate Cancer Biopsy After Abnormal PSA
Prostate cancer is the most common cancer among men in Israel, with about 3,000 new cases diagnosed annually. However, not all prostate tumors behave the same way; some grow slowly and may not require immediate treatment, while others are more aggressive and need early intervention. This creates a challenge in distinguishing which patients need treatment and which can be monitored without invasive procedures.
The initial screening often involves measuring PSA (prostate-specific antigen) levels in the blood. Elevated PSA can raise suspicion of cancer but is not definitive, as benign prostate enlargement or inflammation can also cause high PSA. Historically, many men with elevated PSA underwent biopsies, but many of these proved unnecessary, either showing no cancer or indolent tumors that did not require treatment.
Biopsy remains the only definitive method to diagnose prostate cancer but is invasive and carries risks such as discomfort, bleeding, and infection. Therefore, recent medical practice emphasizes more precise risk assessment before proceeding to biopsy. Dr. Itai Sternberg, a urology expert, explains that an abnormal PSA result now prompts further evaluation rather than immediate biopsy. This includes MRI scans, additional blood tests, urine tests, and clinical data review.
A new molecular urine test called MyProstateScore 2.0 (MPS2) analyzes 18 biological markers linked to prostate cancer and combines them with clinical information to estimate the risk of clinically significant cancer. The test is noninvasive and simple, requiring only a urine sample. If MPS2 indicates low risk, doctors may recommend continued monitoring instead of biopsy. If the risk is higher, further diagnostic steps like MRI or biopsy may be advised.
This approach aims to reduce unnecessary biopsies while ensuring significant cancers are not missed. The test can also assist in managing patients already diagnosed with low-risk tumors by helping decide if active surveillance is appropriate or if treatment should be considered. Dr. Sternberg emphasizes that MPS2 is an additional tool to inform clinical decisions and does not replace biopsy when cancer diagnosis is needed.
While promising, the urine test cannot definitively confirm or exclude cancer and must be interpreted alongside other clinical findings. The goal is to balance early detection of treatable cancers with avoiding overtreatment and invasive procedures for indolent cases. This personalized approach reflects modern medicine’s effort to tailor care to each patient’s risk profile and reduce unnecessary interventions.
