Oncology & Hematology Coding Alert

The 4Kscore Test measures the plasma levels of four different prostate-derived kallikrein proteins: total PSA, free PSA, intact PSA and human kallikrein 2 (hK2). This test will help your physician make a prediction for a high-grade prostate cancer (Gleason score 7 or higher) if a prostate biopsy were to be performed. Besides the lab tests, the code also covers an algorithm based on patient age, nodule status and prior biopsy, which enables your physician to calculate a risk score.

Why 4Kscore Test? There are several protocols for the diagnosis of prostate cancer since the U.S. Preventive Services Task Force (USPSTF) assigned a grade of D (recommending against screening) for prostate-specific antigen (PSA)-based screening for prostate cancer in men aged ≥75 years in 2008 and for men of all ages in 2012. The National Comprehensive Cancer Network (NCCN) included the 4Kscore® as a recommended test in the 2015 and 2016 NCCN Guidelines for Prostate Cancer Early Detection.

Impact of USPSTF recommendations: Researchers have observed a decline in the positive biopsies since 2012. According to Fleshner et al. 2017, ‘Rates of PSA screening decreased by 3-10% in all age groups and across most geographical regions of the USA. Rates of prostate biopsy and prostate cancer incidence have declined in unison, with a shift towards tumours being of higher grade and stage upon detection.’

Read more: You can read more details about the impact of USPSTF recommendations in ‘The effect of the USPSTF PSA screening recommendation onprostate cancer incidence patterns in the USA,’ available at: https://www.ncbi.nlm.nih.gov/pubmed/27995937.