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 Dec 2023. 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.