The 4Kscore was developed to help aid physicians in determining if their patient with an abnormal prostate specific antigen (PSA) blood test or prostate exam may require a prostate biopsy. The 4Kscore provides a percent risk (ranging from 1-95%) of a patient having aggressive prostate cancer on biopsy. This is computed using several different factors (described below). This test has been shown to be far more accurate than PSA in determining if a patient may have aggressive prostate cancer. Unlike PSA, the 4Kscore is not influenced by benign prostate conditions, such as infection or an enlarged prostate. 

Risk Interpretation:

This section discusses the risk findings of your 4Kscore. In this example, the risk is "low". Your report may indicate a different risk interpretation (such as "moderate" or "high risk"). In this example, the report indicates that there is a 95% chance the patient will NOT have aggressive disease on prostate biopsy. The higher this number, the lower your chance of having aggressive prostate cancer upon biopsy. For the 4Kscore, aggressive disease is defined as a diagnosis greater than or equal to Gleason 7 prostate cancer. Thus, in this example, there is a 95% chance that the patient does NOT have Gleason 7 or higher prostate cancer.


Lastly, the test also may predict the probability that a patient will develop distant metastases in the next ten years. This percentage, shown here as 99.8%, suggests that this particular individual has a 99.8% chance (out of 100%) that he will NOT have prostate cancer that has spread outside of the prostate to areas beyond the pelvis. The higher this number, the lower the risk of distant metastases.  


Clinical Information: This section describes your individual clinical information, which includes the results of your digital rectal examination (DRE), and your prostate biopsy status. 

Test Information: 

This section describes how the 4Kscore was validated, the biomarkers used in the 4Kscore algorithm, and how you and your health care provider should use the result to decide if a biopsy should be performed. 


As previously mentioned, the 4Kscore was designed to determine a patient's risk of having a Gleason Score 7 or higher prostate cancer should they receive either an initial or a repeat biopsy. The score is computed using several different factors, such as Total PSA, Free PSA, Intact PSA, Human Kallikrein-2 (hK2, an enzyme that is prostate specific and can break bonds in proteins), as well as the patients age, prostate exam findings, and prostate biopsy history. All these factors go into a special mathematical equation that results in your final score. 


According to the research behind the test, if your 4Kscore is greater than 7.5%, you may need a prostate biopsy. However, the decision to undergo a biopsy should be individualized and considered after a thorough discussion with your health care provider.

Finally, the last paragraph describes a study that found the 4Kscore may determine risk of poor long term outcomes. Men with a 4Kscore of 7.5% or less had less than a 1% risk of having prostate cancer that spread far away from the prostate within 20 years.

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