Joseph C. Presti, Jr., MD, FACS, presented “Changes in Prostate Cancer Presentation Following the 2012 USPSTF Screening Statement” for the Grand Rounds in Urology audience in October 2020.
How to cite: Presti, Joseph C. “Changes in Prostate Cancer Presentation Following the 2012 USPSTF Screening Statement” October 2020. Accessed Aug 2025. https://grandroundsinurology.com/changes-in-prostate-cancer-presentation-following-the-2012-uspstf-screening-statement/
Changes in Prostate Cancer Presentation Following the 2012 USPSTF Screening Statement – Summary:
Joseph C. Presti, Jr., MD, FACS, urologist at Kaiser Oakland and Regional Leader of Urologic Oncology Surgery for Kaiser Permanente California, reviews data compiled by Kaiser Permanente Northern California in order to discuss how the 2012 United States Preventive Services Task Force (USPSTF) screening statement, which includes the claim that “the harms of screening outweigh the benefits,” has impacted prostate cancer screening practices. Dr. Presti outlines the research process used, which included looking at screening-eligible men and assessing the annual rates of PSA testing, prostate biopsy, cancer incidence, and metastatic disease incidence over the course of a pre-guideline period (2010-2011) and a post-guideline period (2014-2017). The researchers found that although the eligible screening population grew from 404,000 to 524,000, screening rates decreased from 42% to 29%, biopsy rates went from 1.2% to .5%, and prostate cancer detection decreased from 2063 diagnoses to 994 in 2014 but increased to 1528 in 2017. Concerningly, metastatic prostate cancer incidence increased significantly post-statement. Dr. Presti concludes by summarizing the data and discussing the strengths (ability to define a screening-eligible population and a large, diverse sample size) and weaknesses (inability to access family history or look for indolent cancers) of the study.
ABOUT THE AUTHOR
Joseph C. Presti, Jr., MD, FACS, is an Adjunct Investigator in the Division of Research and a Physician Researcher in the Delivery Science & Applied Research Physician Researcher Program at Kaiser Permanente in Oakland, California. He is also the Regional Leader for Urologic Oncology Surgery with the Kaiser Permanente Medical Group. Dr. Presti specializes in the evaluation and treatment of urologic cancers. His research focuses on refining detection strategies for prostate cancer.
Dr. Presti earned his medical degree from the University of California, Irvine. He then completed an internship and residency in urology from the University of California, San Francisco. Dr. Presti completed a fellowship in Urologic Oncology at the Memorial Sloan-Kettering Cancer Center in Manhattan, New York.
Dr. Presti’s early work investigated biopsy strategies for improving prostate cancer detection. His current work includes developing and evaluating a risk calculator that uses simple clinical variables to predict a patient’s risk of developing an aggressive prostate cancer. Dr. Presti also studies prostate cancer screening and detection, and he is currently working with the Kaiser Permanente Medical Group’s Department of Adult and Family Medicine to refine their shared decision-making program, which aims to maximize benefits and minimize harms from prostate cancer screening. Dr. Presti also serves as the co-clinical lead for the National KP Prostate Cancer Screening Guideline Team.
