Urine-based testing for prostate cancer: Anyone using this technique?

These urine tests are somewhat new, Here’s a list of some of the available tests.

Dr used the test 16 years ago before it was widely used.

Have to be cautious about the term “false positives” with these tests.

For example, there are rarely false positives with PSA tests. Remember that a PSA test is not a prostate cancer test. A PSA test result is simply indicative of an elevated PSA, and unless there’s an error in the lab, it’s always correct.

A positive PSA test is like a “check engine” light in a car, indicating that “something” may be wrong “somewhere.”

It’s understood that if there is a positive PSA - it’s actually a false assumption to assume that it’s cancer.

What’s necessary is then to take further diagnostic steps - like diagnosing a “check engine” light in a car - to rule out other factors that might cause an elevated PSA: like a DRE prior to a PSA test, UTI, prostatitis, rigorous bicycle-riding, or many other reasons….or it might be prostate cancer.

None of this is indicative of a false positive - unless one does not understand that a PSA test is not a cancer test.

Responding to the original poster in this thread: my prostate cancer was detected as a result of the urine-based ExoDx test.

For many years my PSA was gradually rising and fluctuted quite a bit from test to test, and I was monitored closely for potential cancer including 3 or 4 MRI's and several biopsies at a center of excellence up until March of 2023. I had to switch Urologists in 2023 and at my first appointment with a new Urologist in June of 2023 I had a DRE which was normal and a PSA which also showed no change from the March 2023 PSA. I asked the urologist at that appointment about the newer tests that looked for biomarkers of Prostate Cancer in blood or urine samples and the urologist recommended the ExoDx test. I had that test and the results indicated a 33% chance of clinically significant prostate cancer. Following the ExoDx test result I had an MRI which was completely clear but went ahead with a saturation biopsy at the recommendation of the urologist 'just to be sure' that there was no cancer. Two of 24 cores from the saturation biopsy showed a small percentage (4%) of Gleason 4+5 cancer. I had a prostatectomy 6 weeks later and the pathology report on the complete prostate downgraded the Gleason score to 4+3 with tertiary pattern 5. Needless to say, I am a strong believer in using the more advanced tests to supplement routine PSA's and DRE's.

Contributor @jeffmarc posted a chart above which shows that the EpiSwitch test is probably a better test overall than the ExoDx test at this point, but in my case the ExoDx test did demonstrate the ability to predict the presence of a very small amount of cancer that would not otherwise have been detected by just the conventional PSA, DRE, and MRI. My case also demonstrates one of the benefits of surgery over radiation in that the post-surgery pathology report was different than the pathology results on the more limited sampling from the biopsy. I continue to have PSA checks every 3 months and all have been undetectable.