Prostate cancer remains one of the most common cancers in men worldwide. Early detection is key to successful treatment, but current screening tools like PSA tests can miss cancers or produce false positives. Recently, researchers at Johns Hopkins University have discovered a urine-based RNA biomarker panel that detects prostate cancer with remarkable accuracy, even when PSA levels are normal.
This new approach could change the way men are screened, potentially catching cancers earlier and reducing unnecessary biopsies.
Understanding the New Urine Test
The test looks for three specific RNA biomarkers in urine:
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TTC3
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H4C5
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EPCAM
These RNA molecules are linked to prostate cancer cells. When present in urine, they can signal the presence of cancer even if PSA results are inconclusive.
How It Works
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A urine sample is collected after a gentle prostate massage, which releases prostate cells into the urine.
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The RNA biomarkers (TTC3, H4C5, EPCAM) are extracted and measured using advanced molecular techniques.
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A composite score indicates whether the biomarkers suggest the presence of prostate cancer.
The test is non-invasive, simple to administer, and could easily integrate into routine prostate screening protocols.
Diagnostic Accuracy
In validation studies, this urine biomarker panel showed very high sensitivity and specificity, meaning it could correctly identify both men with and without prostate cancer.
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Sensitivity: High probability of detecting true positives
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Specificity: Low probability of false positives
By combining these biomarkers, the panel improves detection rates for men who might otherwise have “normal” PSA results but harbor significant disease.
Advantages Over Traditional PSA Testing
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Non-invasive: Only a urine sample is needed
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Early detection: Can find cancers that PSA might miss
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Reduced overtreatment: Lowers risk of false positives leading to unnecessary procedures
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Precision screening: Helps identify which men truly need further diagnostic work like MRI or biopsy
Who Could Benefit
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Men with normal PSA but high risk (family history, African American men, or age over 50)
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Men considering a first PSA test but wanting more accurate results
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Those who want to reduce the number of unnecessary biopsies
Limitations and Next Steps
While promising, this test is still under research and not yet widely available commercially. Ongoing studies aim to:
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Validate results in larger, multi-center trials
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Determine how it performs across different stages of prostate cancer
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Integrate it with existing screening protocols for cost-effectiveness and accessibility
How This Could Change Prostate Screening
The introduction of RNA biomarkers in urine has the potential to:
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Make prostate screening less stressful and more accurate
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Reduce reliance on PSA as the sole screening tool
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Detect cancers earlier, improving outcomes and survival rates
Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice. Always consult your healthcare provider for personalized guidance on prostate cancer screening or any diagnostic tests.
Sources
- Johns Hopkins University. A Sensitive and Specific Non‑Invasive Urine Biomarker Panel for Prostate Cancer Detection. eBioMedicine. 2024.
- Johns Hopkins Medicine. Press Release: TTC3 / H4C5 / EPCAM Urine Test for Prostate Cancer Detection. 2025.
- Becker’s Hospital Review. Urine-Based Prostate Cancer Test: Diagnostic Accuracy and Clinical Implications. 2025.
- LabMedica. Urinary Biomarker Test for Prostate Cancer: Overview and Findings. 2024.
- LifeScience.net. Prostate Cancer Urine Biomarker Panel: Study Details and AUC Values. 2024.
- PubMed. Review of Urinary RNA-Based Biomarkers for Prostate Cancer. 2023.
- PubMed. Urinary Biomarker Panel and Other mRNA Markers for Prostate Cancer Detection. 2023.
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