This blood-based prostate cancer biomarker helps predict aggressive prostate cancer.

What is the 4K test for prostate cancer?

The 4Kscore Test can help to reduce the risk of unnecessary biopsies for patients with an abnormal prostate specific antigen (PSA) blood test or prostate exam. The 4Kscore Test is FDA approved and studies conducted with more than 20,000 men in the US and Europe have confirmed the test's effectiveness.

The 4Kscore Test, commonly called the 4K test, is a blood test that measures the level of  four prostate-specific biomarkers (Total PSA, Free PSA, Intact PSA, and human kallikrein 2 [hK2]) and your clinical information. The 4Kscore® Test result assesses your probability of aggressive prostate cancer if a biopsy were performed and has been shown to categorize long-term risk of cancer metastasis or of dying from prostate cancer. The test provides a percent risk (ranging from 1-95%) of a patient having aggressive prostate cancer that will be detected with a prostate biopsy. When used to determine if a patient may have aggressive prostate cancer, the 4Kscore has been proven to be much more accurate than the PSA test. A 4Kscore <5.0 is associated with decreased likelihood of a Gleason score ≥7 on biopsy. Your physician will evaluate your 4Kscore result, along with your clinical information, and discuss options for next steps. Compared to the PSA test, this test is not affected by benign (non-cancerous) prostate conditions, which include an enlarged prostate or infection. As such, the 4Kscore gives healthcare providers a much clearer picture of whether or not aggressive prostate cancer is present.

4K Video

Learn about the 4Kscore® test that provides insights into a patient’s individual risk for prostate cancer and whether or not a biopsy or re-biopsy is warranted.

Understanding Your 4K Results

The 4K results are presented with a percent risk of 1-95% of someone having aggressive prostate cancer on biopsy. View a sample 4K results report and learn more about how to interpret the report. Please note that you should always discuss your test results with you healthcare provider first.


Below is an initial list of frequently asked questions about the 4Kscore® Test.

Who should consider a 4Kscore Test?

The 4Kscore Test is appropriate for the following men:

  • Men 45-54 years old and total PSA ≥2 ng/mL and/or abnormal DRE
  • Men 55-75 years old and total PSA ≥3 ng/mL and/or abnormal DRE
  • Men ≥76 years old and total PSA ≥4 ng/mL and/or abnormal DRE
What does the 4Kscore Test measure?

The 4Kscore measures 4 kallikreins (proteins) in the blood: Total PSA, FreePSA, Intact PSA and hK2. These results are combined with clinical information into an algorithm to determine a score that reflects the risk of having prostate cancer. See a 4Kscore sample result report and learn more about interpreting them.

What do my 4Kscore Test results mean?

It’s important for you to talk to your healthcare provider about any test results. In general, the 4Kscore results include a range for probability of prostate cancer risk:

  • Low risk: 1%-7.5%
  • Intermediate risk: 7.5%-20%
  • High risk: 20%->90%

The 4KScore also calculates a probability of not developing distant metastases within the next 10 years. See a sample of a 4Kscore result report and learn more about how to interpret these results.

Are there any prostate cancer biomarker (PCM) tests that could help me decide if I need to have a prostate biopsy?

Although there are many factors that contribute to your healthcare provider’s decision to conduct a prostate biopsy, there are several urinary and blood based PCMs that may help guide you and your physician through the decision of conducting a prostate biopsy. These include:

Genetic tests also may be worth considering if you have a family history of prostate cancer, breast cancer, ovarian cancer or colorectal cancer. These genetic tests are recommended for men who are determined through genetic counseling to be at potential risk for hereditary cancer:

What is the benefit of the 4Kscore Test?

The benefits of the 4Kscore® Test are the following:

  • It provides you and your physician with the probability of finding high-grade, aggressive prostate cancer (Gleason score ≥7) if you undergo a prostate biopsy
  • It can so the long-term probability of cancer metastasis or death from prostate cancer

Both of these test benefits provide you and your physician with more information so that you can make better-informed healthcare decisions.

Is the 4Kscore Test covered by insurance?

The 4Kscore® Test is covered by most leading healthcare insurance plans. Your provider will bill your insurance company, and you will only be responsible for applicable copayment, co-insurance, and/or deductible amounts. For non-covered services, BioReference Laboratories, Inc. and their GenPath division also have self-pay and payment plan options available.

Learn More

Explore more information about the 4Kscore® Test.