TUESDAY, May 19, 2026 (HealthDay News) -- Noninvasive monitoring of low-grade prostate cancer with a urinary biomarker test could reduce the need for biopsies and serial imaging, according to a study published online April 28 in The Journal of Urology.
Jeffrey J. Tosoian, M.D., M.P.H., from Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues developed and validated a nondigital rectal examination urine test to inform whether biopsy is necessary in patients undergoing active surveillance (AS). Diagnostic performance and clinical consequences of urinary testing to determine the need for biopsy were compared to multiparametric magnetic resonance imaging (mpMRI) in 330 patients with grade group (GG) 1 cancer scheduled for AS biopsy.
The researchers found that on biopsy, 9.4 percent of patients upgraded to GG ≥3 and 37 percent to GG ≥2. The MyProstateScore 2.0-Active Surveillance (MPS2-AS) biomarker model provided a higher area under the curve than mpMRI for upgrading to both GG ≥3 (0.82 versus 0.73) and GG ≥2 (0.74 versus 0.64). Prebiopsy MPS2-AS would have avoided nearly two-thirds (64 percent) of unnecessary biopsies while failing to detect only 3.2 percent of GG ≥3 upgrades. Use of Prostate Imaging Reporting and Data System ≥3 would have failed to detect 18 percent of GG ≥3 upgrades and avoided 50 percent of unnecessary biopsies. MPS2-AS performance was consistent across clinically pertinent subgroups, including confirmatory and surveillance biopsy and Black and non-Black patients.
"For patients undergoing monitoring of low-grade prostate cancer, these findings suggest that use of the urine test can reduce the need for invasive biopsies without compromising prompt detection of higher-grade cancers that require treatment," Tosoian said in a statement.
Several authors disclosed ties to the pharmaceutical industry.
