The PSE Prostate Cancer Test is 270% Better Than PSA - YouTube


This Prostate Cancer Test is 270% Better Than PSA - YouTube

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IPCSG Newsletter

A New Blood Test That Could Revolutionize Prostate Cancer Screening: What You Need to Know About EpiSwitch PSE

BLUF (Bottom Line Up Front): A real test called EpiSwitch PSE — developed by UK researchers and now available in the United States — combines a standard PSA reading with five epigenetic biomarkers to detect prostate cancer with 94% accuracy, compared to roughly 55% for PSA alone. The test is not FDA-cleared but is available as a lab-developed test through a CLIA-certified laboratory in Maryland, and is already reimbursed by Medicare, Humana, UnitedHealthcare, and Optum Health. A 2025 real-world study showed it can reduce unnecessary biopsies by up to 79%. For men on active surveillance or navigating elevated PSA results, this test may offer a meaningful additional tool — though it does not replace MRI or biopsy when cancer is suspected. Men should discuss it with their urologist.

What Is This Test and Why Does It Matter?

A viral video making the rounds calls it a test "270% more accurate than PSA." That eye-catching number requires some unpacking, but the underlying science is real and genuinely promising. The test is formally called the EpiSwitch Prostate Screening (PSE) test, developed by Oxford BioDynamics PLC, a spin-out of Oxford University, in collaboration with Imperial College London, Imperial NHS Trust, and the University of East Anglia. It launched in the US market in September 2023.

The viral video's "270% more accurate" claim appears to be a rough calculation derived from the improvement from a 55% PSA accuracy baseline to 94% with PSE added — an improvement the company and independent researchers confirm, but which is better expressed as "a nearly doubling of diagnostic accuracy" rather than 270%. The video's core claims, however, hold up: the PSE test is a real, validated, commercially available blood test that significantly outperforms PSA alone.

How PSA Falls Short — And How PSE Fills the Gap

The standard PSA (Prostate-Specific Antigen) test has been a workhorse of prostate cancer detection for decades, but it has a well-known Achilles' heel: it measures a protein produced by all prostate tissue, not just cancerous cells. Inflammation, infection, benign prostatic hyperplasia (BPH), bicycle riding, and even sexual activity can all push PSA levels up without any cancer being present. Up to three-quarters of men with a high PSA do not actually have cancer, leading to a cascade of anxiety-provoking MRI scans and biopsies that ultimately prove unnecessary for most men who undergo them.

The PSE test is designed for men with unclear PSA results or ongoing prostate concerns, and may help reduce unnecessary biopsies by adding diagnostic clarity.

The Science: What Is Epigenetics and What Does PSE Actually Measure?

Your DNA is the same in virtually every cell of your body — think of it as the fixed text of a book. But epigenetics refers to a layer of chemical regulation that determines which parts of that book get read, and when. Cancer cells alter these regulatory patterns in distinctive ways. There has been increasing evidence that epigenetic modifications, such as histone modifications, are associated with prostate cancer onset. One such modulator is the 3D conformation of chromatin, and research has shown that long-range alterations in chromatin conformations are present in primary prostate tumors and circulating DNA from prostate cancer patients.

The EpiSwitch PSE combines PSA score with five epigenetic biomarkers: DAPK1, HSD3B2, SRD5A3, MMP1, and miRNA98. These biomarkers reflect abnormal 3D chromosomal conformations — structural changes in how DNA folds and interacts — that are characteristic of prostate cancer. The test looks for these distinctive "molecular fingerprints" in a standard blood draw, and delivers results within five business days.

Importantly, unlike PSA, infection, inflammation, recent intervention, prostate size, intimacy, and heavy exercising do not affect this test.

What Does the Research Show?

The foundational peer-reviewed study was published in the journal Cancers in February 2023, based on a pilot study of 147 patients conducted by teams at Imperial College London, the University of East Anglia, and Oxford BioDynamics. The research team evaluated the PSE test, which combines the traditional PSA test with an epigenetic EpiSwitch assay, and found that PSE significantly enhances overall detection accuracy for at-risk men.

The key performance statistics reported for that validation study are:

  • Sensitivity: 86% — meaning roughly 9 out of 10 men with cancer are correctly identified
  • Specificity: 97% — meaning more than 19 out of 20 men without cancer are correctly cleared
  • Overall accuracy: 94% — compared to roughly 55% for PSA alone
  • Positive Predictive Value: 93%

A more recent and larger study, published in July 2025 in a peer-reviewed journal and based on real-world clinical data collected from 187 patients between October 2023 and May 2025, provided the most compelling practical evidence to date. The EpiSwitch PSE blood test improves prostate cancer detection by reducing unnecessary biopsies by up to 79.1% in the clinical setting. Real-world evidence supports its adoption as a minimally invasive, cost-effective reflex test for improving early detection of prostate cancer and its use for high-risk groups in prostate cancer screening.

Real-world clinical adoption has reinforced these findings. Kearney Urology Center in Nebraska reported a 50% reduction in biopsies since adopting EpiSwitch PSE. The urologist there stated he could not imagine running his practice without it.

Where Can US Patients Get the Test?

This is where good news diverges significantly from the UK video's framing. While the test is not yet widely available in the UK through the NHS and carries a private cost of approximately £750 there, the situation for American men is considerably more favorable.

The PSE test is available in the US as a laboratory-developed test (LDT) validated in a centralized high-complexity CLIA-certified laboratory facility in Frederick, Maryland. It is administered through a physician's order, with results returned to the ordering doctor within five business days.

Perhaps most significantly for our members: in the US, the test is reimbursed under its own reimbursement code by several US insurers, including Humana, UnitedHealthcare, Medicare, and Optum Health. This makes it accessible to a large segment of the prostate cancer patient community without out-of-pocket cost barriers.

To discuss ordering the test, physicians or patients can contact Oxford BioDynamics at 888-236-8896 (US), or find ordering information at www.94percent.com.

Important Cautions and What the Test Cannot Do

Honesty is essential here. The PSE test is promising, but several important caveats apply:

It is not FDA-cleared. The EpiSwitch PSE Test is a laboratory-developed test (LDT). It has not been reviewed or cleared by the US Food and Drug Administration. Decisions regarding patient care should not be made on the basis of this test alone, and should incorporate the treating physician's clinical judgment and other available information.

The pilot study was small. The original validation study involved only 147 patients. The 2025 real-world study involved 187 patients. These are encouraging but not yet the large-scale, multi-center, randomized evidence that would earn NICU or USPSTF endorsement. More extensive independent validation is needed.

It supplements, rather than replaces, the diagnostic pathway. A positive PSE test still triggers a prostate MRI (unless already done) and a prostate biopsy to confirm cancer and create a treatment plan. A negative PSE result in a man with elevated PSA may allow him to avoid an immediate biopsy, but ongoing monitoring is still required.

Not yet standard of care. The American Academy of Family Physicians published a review of the EpiSwitch PSE in its September 2025 issue of American Family Physician, noting it as an emerging complementary test, while emphasizing that the USPSTF still recommends shared decision-making around PSA-based screening and recommends against PSA screening in men 70 and older.

Who Should Consider Discussing This Test With Their Doctor?

Based on the current evidence, PSE may be most valuable for:

  • Men with a mildly or borderline elevated PSA who want more information before proceeding to MRI or biopsy
  • Men in high-risk groups (Black men, those with a family history of prostate, breast, or ovarian cancer) who are entering a screening program
  • Men whose PSA remains elevated after a negative biopsy, and where a repeat biopsy is being considered
  • Men on active surveillance who want additional reassurance or a reason to escalate monitoring

The Bottom Line

The EpiSwitch PSE test represents a genuine scientific advance in prostate cancer detection, not hype. The viral video that circulated recently got the spirit right even if some of the numbers were imprecise. For American men — and particularly for IPCSG members navigating the complex landscape of prostate cancer diagnosis and surveillance — this test is a real, available, insured option worth a conversation with your urologist. It won't replace MRI or biopsy, but it may help many men avoid those procedures when cancer is not present, and help flag those who need faster action.

As always, we encourage our members to bring new diagnostic options like this to their care team and make decisions collaboratively.

Testing for Recurrence or Advanced PC

The Short Answer: PSE Was Not Designed for This — And Has Significant Limitations for Already-Diagnosed Patients

This is one of the most important questions any IPCSG member could ask about EpiSwitch PSE, and the honest answer is nuanced. PSE is a powerful tool for one specific job: helping previously undiagnosed men determine whether a rising or elevated PSA is actually caused by cancer. For men already living with prostate cancer — especially those on ADT, Xtandi, Abiraterone, Pluvicto, or other systemic therapies — the picture is considerably more complicated, and the evidence for PSE's usefulness is much thinner.

What PSE Was Designed and Validated For

Every published clinical study on PSE — the foundational 2023 Cancers paper, the 2025 real-world study, the PROSTAGRAM screening work — enrolled men who were being screened or evaluated for the first time with elevated PSA and no confirmed cancer diagnosis. PSE has been researched mainly for screening the general population to discover new prostate cancer cases, not for surveillance of existing cancer. Peer-reviewed statistics for the surveillance use case do not yet exist.

This is a critical distinction. The test's spectacular 94% accuracy figure was earned in a screening population. It has not been validated in post-treatment, post-surgical, or metastatic disease settings.

The Core Technical Problem: PSE Still Depends Heavily on PSA

This is the structural weakness for advanced disease patients, and it deserves plain explanation. Despite its epigenetic sophistication, PSE is not purely an epigenetic test. The EpiSwitch PSE combines PSA score with five epigenetic biomarkers — DAPK1, HSD3B2, SRD5A3, MMP1, and miRNA98. PSA is embedded as a weighted variable in the algorithm that generates the final result. The five epigenetic markers amplify and refine the PSA signal — they do not replace it.

This matters enormously for men on ADT or next-generation hormonal agents like Xtandi or Zytiga, because these drugs suppress PSA to very low or undetectable levels regardless of disease activity. An increase in PSA level may indicate that a man's cancer has started growing again or become resistant to hormone therapy — but doctors cannot predict how long hormone therapy will be effective in suppressing the growth of any individual man's cancer. When PSA is artificially suppressed to near zero by ADT, the PSE algorithm is effectively working with a broken input. A PSA of 0.01 ng/mL fed into the model is likely to push the result toward "low likelihood" regardless of what the epigenetic markers show — not because the cancer is gone, but because the test was never calibrated for this scenario.

A patient on the Mayo Clinic Connect forum with Gleason 9, on Orgovyx/Zytiga with undetectable PSA, asked exactly this question. A community response noted: "PSE is a PSA test plus an epigenetic test to refine results and reduce false positives. You're still getting a big part of it with your PSA." Another participant remarked that for a man with known Gleason 9 on ADT, "the PSE test is designed to figure out whether you have prostate cancer — because you already have it, it will not really give you any more information."

This is the community-level understanding, but it is consistent with the published science.

What About Using PSE to Detect Biochemical Recurrence?

Oxford BioDynamics has stated through its corporate representative on Mayo Clinic Connect that yes, PSE can be used to detect recurrent prostate cancer, because the test analyzes immune cells in the blood that have been at interplay with prostate cancer. PSE has 97% specificity compared to PSA's 53%, so it may serve as a superior early detection tool and help avoid unnecessary MRIs or biopsies due to high PSA scores that aren't actually a reflection of disease recurrence.

This is a reasonable theoretical argument and the company clearly believes surveillance is a viable use case. But stating it is possible is not the same as validating it. There are currently no peer-reviewed prospective studies evaluating PSE specifically in biochemical recurrence populations — men who have had radical prostatectomy or radiation and are now seeing PSA rise from nadir. Until such studies exist and are published, the recurrence surveillance claim remains theoretical.

For Men on Active Systemic Therapy: Three Specific Scenarios

1. Men on ADT with suppressed or undetectable PSA (e.g., mCSPC, mCRPC on Xtandi/Zytiga/Erleada): PSE is likely to have minimal or no diagnostic value. The PSA component of the model is suppressed below the threshold that drives meaningful results. This is your situation, Stephen, and the frank assessment is that PSE was not built for this context.

2. Men post-prostatectomy or post-radiation on no active systemic therapy, with a rising PSA: This is where PSE has its most plausible case for surveillance. If PSA is rising from a post-treatment nadir and the question is "is this biochemical recurrence vs. benign cause," the PSE's superior specificity (97% vs. PSA's 53%) could theoretically reduce unnecessary imaging. However, this application has not been formally validated.

3. Men on intermittent ADT during an off-treatment "holiday," with recovering testosterone and rising PSA: This is arguably the most interesting potential use case — where PSE might add signal over PSA alone as hormone suppression wears off and PSA recovers. Again, no published validation data exists for this scenario.

What Tests Are Validated for Monitoring Advanced PC?

For IPCSG members managing recurrent or advanced disease, the established and guideline-supported monitoring tools remain:

PSA — still the cornerstone for most post-treatment monitoring, despite its limitations.

PSMA PET/CT — now the gold standard for detecting metastatic recurrence in biochemical relapse, far outperforming conventional bone scan and CT imaging. FDA-approved (Pylarify, Illuccix). This is where the real revolution in post-treatment monitoring has occurred in recent years.

ctDNA / Liquid Biopsy — Circulating tumor DNA assays (e.g., Guardant360, FoundationOne Liquid CDx) can detect androgen receptor splice variants (AR-V7), HRR mutations (BRCA1/2), and other actionable alterations that drive treatment resistance. These are validated for advanced disease and increasingly guide treatment selection for mCRPC.

Testosterone monitoring — Essential for men on ADT to confirm castrate levels and detect castration resistance.

Bottom Line for IPCSG Members

PSE is a genuine advance for undiagnosed men navigating an elevated PSA, potentially sparing them unnecessary biopsies. It is not the right tool for monitoring men already in treatment for prostate cancer, particularly those with PSA suppressed by ADT or next-generation hormonal agents. The test's manufacturers acknowledge it can theoretically detect recurrence, but no peer-reviewed validation data supports that claim for post-treatment populations. For men managing advanced disease — including those on ADT combinations, considering Pluvicto, or on intermittent therapy — PSMA PET/CT and ctDNA liquid biopsy represent the more appropriate, better-validated monitoring tools. Discuss any of these options with your oncologist or urologist in the context of your specific treatment history.

Key Sources:

  1. Pchejetski D, et al. "Circulating Chromosome Conformation Signatures Significantly Enhance PSA Positive Predicting Value and Overall Accuracy for Prostate Cancer Detection." Cancers 2023;15(3):821. https://doi.org/10.3390/cancers15030821

  2. EpiSwitch PSE Blood Test Reduces Unnecessary Prostate Biopsies: A Real-World Clinical Utility Study. PubMed Central, July 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12249354/

  3. Mayo Clinic Connect — Patient Forum Discussion on PSE Testing and Recurrence, March 2025. https://connect.mayoclinic.org/discussion/recent-posts-reference-pse-testing/

  4. NCI. "Hormone Therapy for Prostate Cancer Fact Sheet." National Cancer Institute. https://www.cancer.gov/types/prostate/prostate-hormone-therapy-fact-sheet

  5. Urology Times. "EpiSwitch Prostate Screening Blood Test Launches on US Market." September 2023. https://www.urologytimes.com/view/episwitch-prostate-screening-blood-test-launches-on-us-market

 

Verified Sources and Formal Citations

  1. Pchejetski D, Hunter E, Dezfouli M, et al. "Circulating Chromosome Conformation Signatures Significantly Enhance PSA Positive Predicting Value and Overall Accuracy for Prostate Cancer Detection." Cancers 2023;15(3):821. https://doi.org/10.3390/cancers15030821

  2. Lshaker H, et al. "Chromatin Conformation Changes in Peripheral Blood Can Detect Prostate Cancer and Stratify Disease Risk Groups." Journal of Translational Medicine 2021;19(1). https://doi.org/10.1186/s12967-021-02710-y

  3. EpiSwitch PSE Blood Test Reduces Unnecessary Prostate Biopsies: A Real-World Clinical Utility Study. PubMed Central (MDPI, Open Access), accepted June 2025, published July 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12249354/

  4. Oxford BioDynamics PLC. "Oxford Biodynamics Announces US Launch of its 94% Accurate EpiSwitch Prostate Screening Blood Test." BusinessWire, September 26, 2023. https://www.biospace.com/oxford-biodynamics-announces-us-launch-of-its-94-percent-accurate-episwitch-prostate-screening-blood-test-to-men-with-prostate-cancer-risk

  5. Urology Times. "EpiSwitch Prostate Screening Blood Test Launches on US Market." September 2023. https://www.urologytimes.com/view/episwitch-prostate-screening-blood-test-launches-on-us-market

  6. PharmaTimes. "New Prostate Cancer Test Cuts Biopsies by 50% in US." January 2025. https://pharmatimes.com/news/new-prostate-cancer-test-cuts-biopsies-by-50-in-us/

  7. Integrated Care Journal. "New Prostate Cancer Test 'Cuts Biopsies by 50%' in US Real-World Use." February 7, 2025. https://integratedcarejournal.com/new-prostate-cancer-test-cuts-biopsies-50-us-real-world-use/

  8. Prostate Cancer UK. "Can This New Blood Test Diagnose Prostate Cancer with 94% Accuracy?" February 15, 2023. https://prostatecanceruk.org/about-us/news-and-views/2023/02/can-this-new-blood-test-diagnose-prostate-cancer-with-94-accuracy

  9. Top Doctors UK. "What Is a PSE Test and How Accurate Is It?" December 13, 2024. https://www.topdoctors.co.uk/medical-articles/what-is-a-pse-test-and-how-accurate-is-it/

  10. The Focal Therapy Clinic. "Prostate-Specific EpiSwitch (PSE) Test." August 2025. https://www.thefocaltherapyclinic.co.uk/blog/what-is-a-pse-test/

  11. American Academy of Family Physicians. "EpiSwitch Prostate Cancer Screening Test." American Family Physician 2025;112(3):325–326. https://www.aafp.org/pubs/afp/issues/2025/0900/diagnostic-tests-prostate-cancer-screening.html

  12. Oxford BioDynamics PSE Technical Sheet (Intended Use Document). CLIA/LDT Disclaimer and Biomarker Panel Description. https://assets.oxfordbiodynamics.com/PSE_Technical_Sheet.pdf

  13. Pohlman GD, MD. "EpiSwitch Prostate Screening (PSE) Blood Test." Grand Rounds in Urology, September 2024. (Supported by Oxford BioDynamics.) https://grandroundsinurology.com/episwitch-prostate-screening-pse-blood-test/

  14. Rifat UN. "The Prostate Screening EpiSwitch (PSE) Blood Test: A New Evolving Test." Journal of Urology and Renal Diseases 2023;8:1327. https://www.gavinpublishers.com/assets/articles_pdf/The-Prostate-Screening-EpiSwitch-PSE-Blood-Test-A-New-Evolving-Test.pdf

  15. Oxford BioDynamics / 94percent.com — Ordering, requisition forms, and customer service for US physicians and patients. https://www.94percent.com/

This article is provided for educational purposes and does not constitute medical advice. IPCSG members are encouraged to discuss any new diagnostic test with their oncologist or urologist before proceeding. The EpiSwitch PSE test is a laboratory-developed test not yet cleared by the FDA.

 

 

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