Sigrid V. Carlsson, MD, PhD, MPH

Sigrid V. Carlsson, MD, PhD, MPH

Memorial Sloan-Kettering Cancer Center

New York, New York

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.

Disclosures:

Dr. Carlsson has the following disclosures:
Travel reimbursement and honorarium from Ipsen
Travel reimbursement from Carden Jennings Publishing
Advisory board for Prostatype Genomics
Associate Editor, BJUI
Guideline committees: NCCN, AUA, PCF
Research grant support: NIH/NCI (P30-CA008748, U01-CA266535), Prostate Cancer Foundation, American Cancer Society

Talks by Sigrid V. Carlsson, MD, PhD, MPH

Year in Review: Emerging Data and Advances in Screening

Year in Review: Emerging Data and Advances in Screening

Posted by | Feb 2024

Sigrid V. Carlsson, MD, PhD, MPH, presents an overview of advances and emerging trends in prostate cancer screening in 2023. Dr. Carlson begins by presenting data supporting the continued use of routine PSA tests for prostate cancer screening, while highlighting the need for more granular risk stratification based on individual PSA baselines to bridge existing mortality gaps based on individual PSA baselines.

Dr. Carlsson then examines current trends in using genetics for biopsy risk stratification. She presents evidence that the polygenic risk scores which predict prostate cancer incidence are not useful in predicting mortality. She then discusses the role of biomarkers, risk calculators, and MRI-based screening techniques that are available pre-biopsy.

Turning to emerging data, Dr. Carlsson concludes by presenting a selection of national and international ongoing efforts to develop risk-stratified algorithms for early prostate cancer detection. She touches on the European Union’s “Praise U” initiative, Germany’s “PROBASE” trial, the Stockholm 3 trial, and the ProScreen study.

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Screening and Prevention of Prostate Cancer 2021 (Part 3): Incorporating MRI for Early Detection

Screening and Prevention of Prostate Cancer 2021 (Part 3): Incorporating MRI for Early Detection

Posted by | Jun 2021

In the final part of a 3-part series, Sigrid V. Carlsson, MD, PhD, MPH, Assistant Attending Epidemiologist at Memorial Sloan Kettering Cancer Center, considers the current role of MRI in early detection of prostate cancer. She explains that while MRI is a useful screening tool, it is not foolproof, and its accuracy varies widely depending on user expertise. For this reason, using a negative MRI to justify not getting a biopsy is not always strongly advised. However, many studies are underway that may identify combinations of MRI and biomarker tests that will ultimately help patients avoid more unnecessary biopsies.

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Screening and Prevention of Prostate Cancer 2021 (Part 2): Who Needs a Biopsy?

Screening and Prevention of Prostate Cancer 2021 (Part 2): Who Needs a Biopsy?

Posted by | Jun 2021

In part 2 of a 3-part series, Sigrid V. Carlsson, MD, PhD, MPH, Assistant Attending Epidemiologist at Memorial Sloan Kettering Cancer Center, goes over her 5 Golden Rules for prostate cancer testing, which are intended to minimize overdiagnosis and overtreatment while also making sure that significant disease is not missed. Rule 1 is to get consent and engage in shared decision-making with patients. Dr. Carlsson notes that this can sometimes be difficult since the numerous decision aids available are often difficult to use and understand. The second rule is not to screen men who will not benefit, for instance, older men with multiple comorbidities and short life expectancies. Dr. Carlsson does observe, however, that instituting an age cutoff does not necessarily make sense, and that physiologic assessment of life expectancy may be a more useful metric. In rule 3, Dr. Carlsson advises clinicians not to biopsy patients without a compelling reason, since prostate biopsies may lead to infectious complications and hospitalization. She then lays out the options for risk stratification, such as risk calculators, biomarker tests, and MRI. Rule 4 recommends against treating low-risk disease since, as Dr. Carlsson explains, active surveillance is a safe strategy over longer follow-up for appropriately selected patients with Grade Group 1 prostate cancer when following a well-defined monitoring plan. Finally, rule 5 exhorts clinicians to send patients who require treatment to a high-volume provider. This is key, Dr. Carlsson argues, since evidence shows that there is a large degree of heterogeneity among surgeons regarding functional and oncological outcomes after prostatectomy, and it takes approximately 250 surgeries for a surgeon to really master the procedure.

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Screening and Prevention of Prostate Cancer 2021 (Part 1): Evidence for PSA Screening

Screening and Prevention of Prostate Cancer 2021 (Part 1): Evidence for PSA Screening

Posted by | Jun 2021

In part 1 of a 3-part series, Sigrid V. Carlsson, MD, PhD, MPH, Assistant Attending Epidemiologist at Memorial Sloan Kettering Cancer Center, looks at the evidence supporting widespread prostate specific antigen (PSA) screening. She looks at a range of large studies with long follow-up that demonstrate a reduction in prostate cancer mortality of approximately 30% as a result of widespread PSA screening. Dr. Carlsson also looks at how PSA screening decisions can be made by taking other risk factors into account in order to minimize unnecessary testing. She also notes that the loss in quality-adjusted life years somewhat offsets the benefits of widespread screening. She concludes by introducing her 5 Golden Rules of testing to keep the benefits and reduce the harms.

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