PCA3 score

Click for an information sheet on PCA3

What is the PCA3 score?

This is a new genetic test that determines whether products of genes associated with prostate cancer are present in the urine of men.

How do I get the test done?

A sample of urine that contains prostate cells is needed. This is obtained from the first part of the urine passed after the prostate has been examined with a finger. The sample is cooled and sent for analysis. No blood is taken.

What does the PCA3 score tell you? 

A numerical score is obtained and the value of this gives an idea on how likely prostate biopsies are to show prostate cancer. The data are new, but a rough idea using the PCA3 score alone is shown below:

PCA3 Score

Probability of prostate cancer on  biopsy













As you can see, it does not rule in or rule out prostate cancer, and the chance of prostate cancer is variable. 

However, the PCA3 score is significantly better than PSA alone, and when used in conjunction with the PSA value, digital rectal examination findings, age, prostate size and percentage free PSA, it is possible to make a better estimate about the risk of biopsy-detectable prostate cancer. The data have been used to generate a research model to give an overall probability. This has been presented at the European Association of Urology annual meeting 2008.This seems to be the best, but has not yet been published. We have this but we are unable to quote it until it is actually  published.

A prostate biopsy is still necessary to prove if cancer is present or not.

Does the PCA3 score tell you how serious the cancer is, and whether treatment might be necessary?

This year, two scientific studies have been published that show the PCA3 score does and does not correspond with the severity of prostate cancer. As such, it is not possible to know yet with any reliability whether the PCA3 score is likely to be able to tell who should and who should not have treatment for prostate cancer.

How does the PCA3 score compare with PSA?

The results are more accurate than PSA alone, but are not sufficient to rely on in isolation. The PCA3 score is not affected by the size of the prostate, unlike PSA. It is also less affected by urinary infections, which can make PSA completely unreliable.  It is not yet entirely clear if drugs can affect PSA. It is possible that reduced levels of testosterone or dihydrotestosterone that can occur with age or on drugs (e.g. LHRH agonists, bicalutamide or finasteride) might influence the results.


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