Published in
2022
March 2022, Volume 9, Issue 2, Pages 173-180; doi: 10.1097/UPJ.0000000000000291
IsoPSA Reduces Provider Recommendations for Biopsy and Magnetic Resonance Imaging in Men with Total Prostate Specific Antigen ≥4 ng/mL: A Real-World Observational Clinical Utility Study Jason M. Scovell, Daniel Hettel, Robert Abouassaly, Nima Almassi, Ryan Berglund, Todd Breaux, Christopher Weight, Wahib Isac, Anna Zampini, Elizabeth Stark, Robert Rochelle, Aimee Kestranek, Mark Stovsky, and Eric A. Klein
Objective Methodology
To assess the impact of the IsoPSA test for prostate cancer risk assessment on provider patient management decisions in a real-world clinical setting. Enrolled 900 men being evaluated for prostate cancer; 734 met inclusion criteria (age >50 years, total serum prostate specific antigen (PSA) ≥4 and <100 ng/mL and no history of prostate cancer). Compared biopsy and MRI recommendations prior to and after receiving IsoPSA results. Primary outcome: Number of biopsy and MRI recommendation changes occurring after IsoPSA testing.
Results
IsoPSA results were used to affirm or modify provider recommendations for prostate biopsy and/or MRI. • 60% change in recommendations for biopsy
- 90% of patients initially recommended for biopsy were not recommended for biopsy after clinicians received IsoPSA results ≤ 6
- 43% of patients initially NOT recommended for biopsy were recommended for biopsy after clinicians received IsoPSA results > 6
• 55% reduction in recommendations for prostate biopsy overall
Conclusion
In a real-world clinical setting, providers readily adopted IsoPSA with substantial reductions in the rate of recommended prostate biopsies and MRIs in patients with elevated PSA values (≥4 ng/mL). There was a high concordance between recommendation for or against prostate biopsy and the IsoPSA result. IsoPSA could help avoid biopsy-related discomfort and complications and reduce overdetection of indolent disease.