Trial reportThe Journal of urology2011
A multicenter study of [-2]pro-prostate specific antigen combined with prostate specific antigen and free prostate specific antigen for prostate cancer detection in the 2.0 to 10.0 ng/ml prostate specific antigen range.
Trial report in The Journal of urology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 229 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
229 citing papers in PubMed, 6 syntheses or guidelines pooled it, 488 citations in OpenAlex.
- Guideline of guidelines: a critical appraisal of the evidence for PSA retesting intervals.BJU international · 2025Pooled it
- Prediction models for prostate cancer to be used in the primary care setting: a systematic review.BMJ open · 2020Pooled it
- Assessment on clinical value of prostate health index in the diagnosis of prostate cancer.Cancer medicine · 2019Pooled it
- NCCN Guidelines Insights: Prostate Cancer Early Detection, Version 2.2016.Journal of the National Comprehensive Cancer Network : JNCCN · 2016Guideline
- Clinical use of [-2]proPSA (p2PSA) and its derivatives (%p2PSA and Prostate Health Index) for the detection of prostate cancer: a review of the literature.Korean journal of urology · 2014Pooled it
- Diagnostic ability of %p2PSA and prostate health index for aggressive prostate cancer: a meta-analysis.Scientific reports · 2014Pooled it
- Prostate Health Index and Prostate Health Index Density as Diagnostic Tools for Improved Prostate Cancer Detection.BioMed research international · 2020Trial
- Can urinary PCA3 supplement PSA in the early detection of prostate cancer?Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2014Trial
- Article
- PHI for adverse pathology and PHI density for upgrading: two complementary predictors in localized prostate cancer.Prostate cancer and prostatic diseases · 2026Article
- The Complementary Roles of the Prostate Health Index and Multiparametric Magnetic Resonance Imaging in Optimizing the Detection of Clinically Significant Prostate Cancer in Patients With Prostate-Specific Antigen Levels Below 10 Ng/mL.International journal of urology : official journal of the Japanese Urological Association · 2026Observational
- Early-Onset Prostate Cancer: Epidemiology, Risk Factors, Biology, Clinical Features, Management, and Early Detection.MedComm · 2026Review
- Volume-adjusted p2PSA-derived indices for predicting prostate cancer: the PROPHET study.International journal of clinical oncology · 2026Observational
- Transperineal Versus Transrectal Prostate Biopsy in the MRI-Targeted Era: A Contemporary Narrative Review.Biomedicines · 2026Review
- Added value of PHI in predicting lymph node invasion in prostate cancer: an external validation.BMC urology · 2026Article
- Clinical utility of the prostate health index density in patients with negative mpMRI or prior negative biopsy.Prostate international · 2026Article
- Observational
- Prostate Cancer Screening in Contemporary Era: PSA-Based Testing and Risk-Adapted Approaches.Cancers · 2026Review
- Combining Serum Prostate Health Index With Urinary PCA3 and TMPRSS2:ERG RNA Testing Improves Detection of Clinically Significant Prostate Cancer.JU open plus · 2026Article
- Utility of the PROSTest, a Novel Blood-Based Molecular Assay, Versus PSA for Prostate Cancer Stratification and Detection of Disease.The Prostate · 2026Article
169 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
17 authors at 10 institutions in 2 countries.
Funding
Abstract
purposeProstate specific antigen and free prostate specific antigen have limited specificity to detect clinically significant, curable prostate cancer, leading to unnecessary biopsy, and detection and treatment of some indolent tumors. Specificity to detect clinically significant prostate cancer may be improved by [-2]pro-prostate specific antigen. We evaluated [-2]pro-prostate specific antigen, free prostate specific antigen and prostate specific antigen using the formula, ([-2]pro-prostate specific antigen/free prostate specific antigen × prostate specific antigen(1/2)) to enhance specificity to detect overall and high grade prostate cancer. MATERIALS AND
methodsWe enrolled 892 men with no history of prostate cancer, normal rectal examination, prostate specific antigen 2 to 10 ng/ml and 6-core or greater prostate biopsy in a prospective multi-institutional trial. We examined the relationship of serum prostate specific antigen, free-to-total prostate specific antigen and the prostate health index with biopsy results. Primary end points were specificity and AUC using the prostate health index to detect overall and Gleason 7 or greater prostate cancer on biopsy compared with those of free-to-total prostate specific antigen.
resultsIn the 2 to 10 ng/ml prostate specific antigen range at 80% to 95% sensitivity the specificity and AUC (0.703) of the prostate health index exceeded those of prostate specific antigen and free-to-total prostate specific antigen. An increasing prostate health index was associated with a 4.7-fold increased risk of prostate cancer and a 1.61-fold increased risk of Gleason score greater than or equal to 4 + 3 = 7 disease on biopsy. The AUC of the index exceeded that of free-to-total prostate specific antigen (0.724 vs 0.670) to discriminate prostate cancer with Gleason 4 or greater + 3 from lower grade disease or negative biopsy. Prostate health index results were not associated with age and prostate volume.
conclusionsThe prostate health index may be useful in prostate cancer screening to decrease unnecessary biopsy in men 50 years old or older with prostate specific antigen 2 to 10 ng/ml and negative digital rectal examination with minimal loss in sensitivity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.