"A painless urine test https could soon help doctors tell when a high prostate https antigen PSA https level means a dangerous cancer https or when its a sign of a more benign condition that may not need further treatment a new study shows. The test looks for a genetic mistake thats present in about half of all cases of prostate cancer https This mistake a case of two genes that come together and fuse doesnt appear to occur anywhere else in the body or even in precancerous conditions making it a highly specific marker for the disease. When the genes fuse says study researcher Scott A. Tomlins MD PhD a pathologist at the University of Michigan Health System in Ann Arbor its a lot like flipping a switch. And that gene when its turned on can cause cancer https Refining PSA Test Results This would be done for men who have been identified as having an elevated PSA Tomlins says. Currently doctors are split over the value of PSA testing for prostate cancer https Thats because PSA can be elevated even when cancer https is not present for example when the prostate is inflamed as in the case of prostatitis https or enlarged as in benign prostatic hyperplasia https BPH httpsmen.webmd.comprostateenlargementbph. Yet high PSA levels over four typically lead to a biopsy which can cause discomfort anxiety https and in rare cases lead to complications like infections. Biopsies https are also expensive costing somewhere between  and . Researchers say that right now when PSA levels are elevated its up to patients and their doctors to figure out what to do next. There really arent very good tools to utilize to help make that decision Tomlins says. We wanted to see if our urine markers could be useful in that situation. Testing for Prostate Cancer Biomarkers For the study which is published in the journal Science Translational Medicine researchers tested the urine of  men with elevated PSA levels who had gone on to have needle biopsies or surgery to remove their prostates. The test uses strands of artificially created oligonucleotides the building blocks of DNA and RNA which are built to match the code of the fused gene which is called TMPRSSERG. To increase the accuracy of the test researchers also looked for another gene called prostate cancer antigen  or PCA which is also found in urine. The two tests together appeared to generate both sensitive and specific results. Sensitive means its unlikely that the test would miss a case of cancer. Specific means that the test is unlikely to be positive if cancer isnt really present. Based on the levels of PCA and TMPRSSERG detected the men were given numerical scores that were classified as being high medium or low. Those scores were then compared to the biopsy results. The men in the highest group have a risk of cancer on biopsy of about  and those in the lowest group have a risk of cancer of about  says Tomlins. Researchers then narrowed their analysis to see how the urine test scores matched the mens Gleason score which helps doctors gauge how aggressive a cancer may be. What weve found is that your risk of having an aggressive cancer if youre in the high group is about  and if youre in the low group the risk of having an aggressive cancer is only about  Tomlins says. The company that developed the test GenProbe helped to pay for the study and several authors said they had a personal financial interest in the technology. This is great science says J. Stephen Jones MD chairman of the department of regional urology at the Cleveland Clinic in Ohio. Now that the researchers have validated the test further studies in larger more diverse populations will be important to understand how it is best used. The real key is using this or any test to help drive decisions says Jones who was not involved in the research If it helps me to know who to biopsy or not biopsy thats massively valuable information."