Sigrid V. Carlsson, MD, PhD, MPH, presented “Prostate Cancer Screening in 2023” during the 33rd International Prostate Cancer Update on January 23, 2023, in Vail, Colorado.
How to cite: Carlsson, Sigrid V. “Prostate Cancer Screening in 2023.” January 23, 2023. Accessed Jul 2024. https://grandroundsinurology.com/prostate-cancer-screening-in-2023/
Prostate Cancer Screening in 2023 – Summary
Sigrid V. Carlsson, MD, PhD, MPH, Assistant Attending Epidemiologist at Memorial Sloan Kettering Cancer Center (MSKCC), discusses the current state of prostate cancer screening, focusing on PSA screening, risk calculators, biomarkers, and MRI. She begins with PSA screening, noting that while some organizations suggest foregoing this tool, randomized trials indicate that PSA screening reduces prostate cancer mortality by 30%. Dr. Carlsson cites the Göteborg trial that found PSA testing at a younger age is associated with a greater reduction in prostate cancer mortality. The study found that even beginning PSA screening at age 55 halved the risk of death, when compared to beginning screening at age 60. While PSA screening is known to have poor specificity, Dr. Carlsson contends it is a useful prognosticator, pointing to evidence that PSA level in midlife strongly stratifies long-term risk of prostate cancer. Similarly, other screening tools, such as risk calculators, can be helpful in determining the need for biopsy, but must be calibrated to reflect the treatment population. MRI can be used along with PSA screening to determine whether a biopsy is necessary. Dr. Carlsson then reviews the Göteborg-2 trial, which assessed whether systematic biopsy for all men with an elevated PSA could be replaced by targeted biopsy of only MRI-positive lesions while appropriately detecting clinically significant cancer. She concludes with a discussion of additional studies evaluating the combination of screening tools.
About The 33rd Annual International Prostate Cancer Update:
The International Prostate Cancer Update (IPCU), founded in 1990, is a multi-day CME conference focused on prostate cancer treatment updates with expert, international faculty. It is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer. The 33rd iteration of the meeting occurred January 22-25, 2023 in Vail, Colorado. To view more educational presentations from IPCU 33, visit our collection page.
ABOUT THE AUTHOR
Sigrid V. Carlsson, MD, PhD, MPH, is Director of Clinical Research at Memorial Sloan Kettering Cancer Center’s (MSKCC) Josie Robertson Surgery Center and Assistant Attending Epidemiologist, with dual appointments in MSKCC’s Departments of Surgery (Urology Service) and Epidemiology and Biostatistics. Her line of research focuses on screening and early detection of prostate cancer, including multiplex testing and risk-stratified strategies that incorporate clinical information, biomarkers and magnetic resonance imaging, as recently funded by an NIH/NCI U01 award (PI: Carlsson).
Dr. Carlsson also serves as Associate Professor of Experimental Urology affiliated with the Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, in Sweden, where she is an investigator of two large randomized controlled trials of prostate cancer screening (GOTEBORG-1&2), as recently published in the New England Journal of Medicine (Hugosson J, et al. N Engl J Med 2022). In addition, Dr. Carlsson is Adjunct Senior Lecturer in the Department of Translational Medicine in the Division of Urological Cancers in the Medical Faculty at Lund University, Lund, Sweden.
Dr. Carlsson recently completed a K22 career development award from the NIH/NCI to improve shared decision-making for breast and prostate cancer screening. She serves on the National Comprehensive Cancer Network (NCCN) and is a panel member for the American Urological Association (AUA) guidelines for early detection of prostate cancer. Before pursuing postdoctoral studies in urologic oncology at MSKCC, Dr. Carlsson was a physician in Sweden. She earned her MD and PhD from Gothenburg University in Sweden and earned an MPH from Harvard TH Chan School of Public Health in Boston, Massachusetts.
