How to cite: Collins SP. “Is PSA Screening Still Broken or Finally Fixed?” Grand Rounds in Urology. August 2026. Accessed Oct 2026. https://grandroundsinurology.com/is-psa-screening-still-broken-or-finally-fixed/
Summary
In this presentation from the UroCancer Interdisciplinary Forum (UCIF) 2026, Sean P. Collins, MD, PhD, Professor of Radiation Oncology, University of South Florida, Morsani College of Medicine, Tampa, Florida, uses his own screening journey as an example, discussing how evolving evidence has changed his perspective on prostate-specific antigen (PSA) testing and how he applies current recommendations to his own care.
Dr. Collins reviews contemporary screening guidance, noting that while professional society recommendations differ in certain details, they increasingly support risk-adapted screening based on age, family history, baseline PSA values, life expectancy, and shared decision-making. He describes how serial PSA measurements provide valuable longitudinal information and explains his personal approach to monitoring PSA over time, including the potential role of prostate magnetic resonance imaging (MRI).
Dr. Collins addresses growing interest in secondary biomarker testing following an elevated PSA. Blood-, urine-, and tissue-based assays have expanded the diagnostic toolbox and may help refine biopsy decisions after MRI. He emphasizes that although several commercially available assays are used in practice, comparative evidence remains limited, leaving physicians without clear guidance for selecting among available options.
ABOUT THE AUTHOR
Sean P. Collins, MD, PhD, is a Professor of Radiation Oncology and the Vice Chair of Faculty Affairs at the University of South Florida Morsani College of Medicine in Tampa, Florida. In July 2006, Dr. Collins joined his twin brother Brian on the faculty of the Cancer Center at Georgetown University Hospital as an Attending Physician in Radiation Oncology. Dr. Collins graduated from the Medical Scientist Training Program (MSTP) at the University of Michigan in 2001. Dr. Collins completed both an internship in Surgery and a residency in Radiation Oncology at Georgetown University Hospital. His area of expertise is prostate cancer, for which he treats patients using the CyberKnife®, a technology that allows for more accurate targeting of radiation therapy. Dr. Collins is a physician-scientist, and his work focuses on developing prostate cancer treatment protocols using stereotactic body radiation therapy (SBRT) to minimize the toxicity of radiation dose escalation. To date, he has treated over 2500 prostate cancer patients with SBRT and has presented his work at major meetings and published multiple papers on his experience in peer-reviewed journals.
