Sigrid V. Carlsson, MD, PhD, MPH, presented “Prostate Cancer and Early Detection: Should We Follow the NCCN Guidelines?” during the 27th Annual Perspectives in Urology: Point Counterpoint on November 9, 2018 in Scottsdale, Arizona.

How to cite: Carlsson, Sigrid V. “Prostate Cancer and Early Detection: Should We Follow the NCCN Guidelines?” November 9, 2018. Accessed Nov 2024. https://grandroundsinurology.com/prostate-cancer-and-early-detection-should-we-follow-the-nccn-guidelines/

Prostate Cancer and Early Detection: Should We Follow the NCCN Guidelines? – Summary:

Sigrid V. Carlsson, MD, PhD, MPH, compares the National Comprehensive Cancer Network (NCCN) Prostate Cancer Early Detection v2.2018 guidelines to Memorial Sloan Kettering Cancer Center (MSKCC) recommendations for prostate cancer screening in terms of optimizing oncological benefits and reducing negative effects on quality of life.

This presentation is part of a Point-Counterpoint debate coupled with “Prostate Cancer Screening: The NCCN Perspective” by J. Kellogg Parsons, MD, MHS, FACS.

Shifting the Balance of Prostate Cancer Screening Benefits and Harms

This presentation reviews components of the NCCN Prostate Cancer Early Detection v2.2018 guidelines. These components include baseline evaluation, screening tests, the ages at which to initiate and discontinue screening, frequency of screening, indications for biopsy, and pre-biopsy workup methods that incorporate clinical information, novel biomarkers, and imaging. It will compare the NCCN guidelines with the MSKCC recommendations for prostate cancer screening, which is similarly a risk-based algorithm.

The balance between benefits and harms of prostate-specific antigen (PSA) screening is entirely dependent on how one screens. While screening large populations does improve life years gained, it causes a reduction in quality-adjusted life years (QALYs). Following five straightforward “golden rules” can cause a shift toward a more favorable balance of these benefits and harms.

About Perspectives in Urology: Point Counterpoint

Perspectives in Urology: Point Counterpoint (PCP) is an annual CME-accredited conference devoted to discussing and debating the latest topics in men’s health, general urology, and genitourinary cancers. The conference’s format includes more than didactic lectures. It also includes debates, point-counterpoint discussion panels, and unique case-based presentations. Dr. Carlsson presented this lecture during the 27th PCP in 2018. Please visit this page in order to register for future PCP meetings.

ABOUT THE AUTHOR

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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.