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Urology (Expert Forum)
LOW PSA and Low % Free PSA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
LOW PSA and Low % Free PSA
by Richard__0, Mar 11, 1999 12:00AM
An insurance company has declined my application for
life insurance based on the following lab results:
Total PSA 1.8
Free PSA .3
% Free PSA 16.7%
Everything I've read to date addresses the relationship
of a Total PSA above 4.0 and a low Free PSA %, but does not
address my situation of a LOW Total PSA and a Low Free PSA %.
I am 55 years old and in perfect health in every other area,
have no family history of PC, so should qualify for the
lowest insurance rates available.
Please help me to understand why an insurance company
might classify me as uninsurable.
Thank you.
life insurance based on the following lab results:
Total PSA 1.8
Free PSA .3
% Free PSA 16.7%
Everything I've read to date addresses the relationship
of a Total PSA above 4.0 and a low Free PSA %, but does not
address my situation of a LOW Total PSA and a Low Free PSA %.
I am 55 years old and in perfect health in every other area,
have no family history of PC, so should qualify for the
lowest insurance rates available.
Please help me to understand why an insurance company
might classify me as uninsurable.
Thank you.
Doctor's Answer
by hfhs M.D.-AK, Mar 11, 1999 12:00AM
_
Dear Richard,
I don’t know much about insurance nor do I know what or how a person qualifies for a certain premium. Your PSA is well within normal range, but your free PSA is low. Free PSA is another way to evaluate individuals screened for prostate cancer. Free PSA just as other screening tests have errors known as false positives and false negatives. If your test is a false positive, this would mean that you do not have prostate cancer, but still have a positive screen test. There is nothing you or I can do about your test results except repeat the test or follow-up on the results.
For unknown reasons, the proportion of PSA that is unbound(percent free PSA) is lower in men with prostate cancer than in men with benign prostates. The free PSA test is usually to help decide if a second prostate biopsy is needed rather than an initial screening test. There is no set protocol as to when and how percent free PSA should be used, so clearly it should be individualized. Keep in mind that all test are variable and may need to be repeated to confirm the result.
I would ask your insurance company what their policy is about repeat results or have your urologist write a letter discussing your situation. If you don’t get the answer you want, try another company.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Prostate Cancer
Dear Richard,
I don’t know much about insurance nor do I know what or how a person qualifies for a certain premium. Your PSA is well within normal range, but your free PSA is low. Free PSA is another way to evaluate individuals screened for prostate cancer. Free PSA just as other screening tests have errors known as false positives and false negatives. If your test is a false positive, this would mean that you do not have prostate cancer, but still have a positive screen test. There is nothing you or I can do about your test results except repeat the test or follow-up on the results.
For unknown reasons, the proportion of PSA that is unbound(percent free PSA) is lower in men with prostate cancer than in men with benign prostates. The free PSA test is usually to help decide if a second prostate biopsy is needed rather than an initial screening test. There is no set protocol as to when and how percent free PSA should be used, so clearly it should be individualized. Keep in mind that all test are variable and may need to be repeated to confirm the result.
I would ask your insurance company what their policy is about repeat results or have your urologist write a letter discussing your situation. If you don’t get the answer you want, try another company.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Prostate Cancer
