Anyone familiar with this test and have any thoughts?
from:
I’m not a urologist, but the ongoing discussions about prostate cancer triggered by the ex-president’s condition prompted me to write this blog post, hoping that it might be helpful to some people.
According to the American Cancer Society, one in eight men will be diagnosed with prostate cancer at some point in their lifetime. It is the second most common cancer among men in the U.S. (after lung cancer).
Prostate cancer often has no early symptoms.
The chance of prostate cancer increases with age (up to 50% by age 50, 60%, by age 60, 70% by age 70, and up to 100% by age 100.)
Many of these are small non-significant cancers that do not require immediate treatment. The risk of over-diagnosis, leading to invasive biopsies is increasing with age. At what age harm exceeds benefits is not established, but studies have demonstrated that the quality-adjusted life-years (QALYs) gained are decreasing, albeit still on the positive side, until the age of 75.
The recommendations to stop screening at that age are based on concerns that screening does not have a large impact on mortality and that it is associated with potential harms, including false-positive results that require invasive prostate biopsies, overdiagnosis and overtreatment with treatment complications, such as incontinence and erectile dysfunction.
The problem is that most PC deaths occur in men after the age 80.
Life span is increasing. The number of centenarians in the USA is projected to quadruple in number in 2054. Prostate cancer will become more frequent and stop testing for it at the age of 75 isn’t a good plan.
The PSA test screening for prostate cancer has successfully reduced prostate cancer mortality in the past, but has led to significant problems with overdiagnosis and overtreatment. As a result, many men are subjected to unnecessary prostate biopsies and overtreatment of indolent cancer in order to save one man from dying of prostate cancer.
In the past 10 years, a new test has become available, which can solve the problem.
A novel blood test known as the 4Kscoretest incorporates a panel of four biomarkers (total PSA, free PSA, intact PSA, and human kallikrein-related peptidase 2) and other clinical information in an algorithm that provides a percent risk for a high-grade (Gleason score ≥ 7) cancer on biopsy and distinguishes men with a low risk for aggressive prostate cancer from those with a high risk who need prompt diagnosis and treatment to prevent spread of the cancer to other organs.
The 4Kscore has reportedly yielded a 99% sensitivity and around 95% negative predictive value for the determination of Gleason grade 7 or greater disease.
Thankfully, today there are very effective treatment options available for prostate cancer including the combination of localized and external radiations which, if done by experts in the field, and if the cancer is caught at an early stage, result in a cure of the disease without any life-altering side effects. The key is to detect the cancer at an early stage so that hormonal suppression therapy (with secondary sexual dysfunction and even possible danger of dementia) is not necessary.
For more information on the 4K blood test check this:
https://www.aruplab.com/4kscore
Related:
Finding the Wolf in Sheep’s Clothing: The 4Kscore Is a Novel Blood Test That Can Accurately Identify the Risk of Aggressive Prostate Cancer
Better biomarkers that can discriminate between aggressive and indolent phenotypes of prostate cancer are urgently needed. In the first 20 years of the prostate-specific antigen (PSA) era, screening for prostate cancer has successfully reduced prostate cancer mortality, but has led to significant problems with overdiagnosis and overtreatment. As a result, many men are subjected to unnecessary prostate biopsies and overtreatment of indolent cancer in order to save one man from dying of prostate cancer. A novel blood test known as the 4Kscore® Test (OPKO Lab, Nashville, TN) incorporates a panel of four kallikrein protein biomarkers (total PSA, free PSA, intact PSA, and human kallikrein-related peptidase 2) and other clinical information in an algorithm that provides a percent risk for a high-grade (Gleason score ≥ 7) cancer on biopsy. In 10 peer-reviewed publications, the four kallikrein biomarkers and algorithm of the 4Kscore Test have been shown to improve the prediction not only of biopsy histopathology, but also surgical pathology and occurrence of aggressive, metastatic disease. Recently, a blinded prospective trial of the 4Kscore Test was conducted across the United States among 1012 men. The 4Kscore Test replicated previous European results showing accuracy in predicting biopsy outcome of Gleason score ≥ 7. In a recent case-control study nested within a population-based cohort from Västerbotten, Sweden, the four kallikrein biomarkers of the 4Kscore Test also predicted the risk for aggressive prostate cancer that metastasized within 20 years after the test was administered. These results indicate that men with an abnormal PSA or digital rectal examination result, and for whom an initial or repeat prostate biopsy is being considered, would benefit from a reflex 4Kscore Test to add important information to the clinical decision-making process. A high-risk 4Kscore Test result may be used to select men with a high probability of aggressive prostate cancer who would benefit from a biopsy of the prostate to prevent an adverse and potentially lethal outcome from prostate cancer. Men with a low 4Kscore Test result may safely defer biopsy.
