Prostate Health Index (PHI) Test

The Prostate Health Index (PHI) is a blood test that substantially improves the clinical accuracy of PSA-based prostate cancer screening by combining three measurements — total PSA, free PSA, and the [-2]proPSA isoform (p2PSA) — into a single calculated index. Available at 1,298 Kč through cz.unilabs.online and collected at any Prague Unilabs point, PHI is used to decide whether a prostate biopsy is genuinely necessary in men with mildly or moderately elevated PSA. A standard PSA reading in the 'grey zone' (4–10 ng/mL) leads to unnecessary biopsies in approximately 70% of cases; PHI's higher specificity reduces this substantially, sparing many men an invasive procedure. Recommended for men aged 45+. Results within 3 business days. Rated 4.58/5 across 48 reviews.

Prostate-specific antigen (PSA) testing has been the primary prostate cancer screening tool for decades, but its major limitation is poor specificity: PSA is elevated not only in prostate cancer but in benign prostatic hyperplasia (BPH), prostatitis, and after physical activity involving the prostate. The result is that a large proportion of men with elevated PSA in the 4–10 ng/mL range (the 'diagnostic grey zone') are referred for prostate biopsy when no cancer is present — an uncomfortable procedure carrying risks of infection, bleeding, and urinary complications. The Prostate Health Index solves this by combining three PSA-related measurements in a validated algorithm. Total PSA provides the overall antigen level. Free PSA is the fraction of PSA circulating unbound to serum proteins: a low free PSA percentage (free PSA/total PSA ratio) is associated with higher cancer probability, while benign conditions tend to produce proportionally more free PSA. The [-2]proPSA (p2PSA) is the most cancer-specific isoform of PSA and a direct precursor to active PSA; it is found at disproportionately high concentrations in prostate cancer tissue. The PHI formula combines these three values: PHI = (p2PSA / free PSA) × √total PSA. In clinical validation studies (including the European Randomised Study of Screening for Prostate Cancer, ERSPC), PHI has demonstrated superior sensitivity for clinically significant prostate cancer compared to total PSA or %fPSA alone, while substantially reducing the biopsy rate in men who are ultimately cancer-free. At Unilabs CZ, the PHI test requires a standard venous blood draw with no particularly invasive preparation. Men are advised to avoid activities that apply pressure to the prostate — sexual intercourse, cycling, and heavy exercise — for 48 hours before the draw. After a rectal examination or prostate massage, a two-week delay is recommended. After a prostate biopsy, a two-week waiting period is required before PSA results are interpretable. The urologist uses the PHI result alongside clinical examination, patient history, and imaging findings (if available) to recommend whether a biopsy is warranted. The test itself is a data point — not a diagnostic conclusion. Results are available within 3 business days. The uLékaře.cz interpretation add-on is available for patients who want specialist input before discussing with a urologist.