How the future of prostate cancer screening could improve health outcomes

Sep 4, 2024

The most common cancer type among men in the U.S., prostate cancer doesn’t usually present with symptoms in the early stages. That’s why routine screening is important in achieving better outcomes. But screening for prostate cancer is not always straightforward—from overdiagnosis to overtreatment to racial disparities, prostate cancer screening is not “one size fits all.”

On September 11, experts will discuss current screening trends, guidelines and methods, as well as advancements to address the multiple challenges around prostate cancer screening, at the third and final webinar of the 2024 Prevent Cancer Foundation Dialogue virtual series, presented in partnership with ZERO Prostate Cancer.

Sigrid Carlsson, M.D, Ph.D., is one of those experts. Dr. Carlsson is the Director of Clinical Research at the Josie Robertson Surgery Center and Assistant Attending Epidemiologist in the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics at Memorial Sloan Kettering Cancer Center. She received funding from the Prevent Cancer Foundation in 2018 for her research project on Optimizing prostate cancer screening through the electronic health record and in 2020 for her project Improving prostate cancer screening using innovative technology. Appointed in 2018 to the Prevent Cancer Foundation’s Medical Advisory Board, she provides expertise to the Foundation on scientific developments in cancer prevention and early detection, with a focus on epidemiology, prostate cancer and cancer screening. We asked Dr. Carlsson for a preview of some of the topics to be discussed during the panel discussion.

Note: This interview has been edited for length and clarity.

Q: What do you consider to be one of the biggest challenges facing prostate cancer prevention and early detection?

A: One of the biggest challenges, in my view, is the lack of consistency in guidelines regarding who should be screened, when to be screened, and how often to be screened. This inconsistency can create confusion for men seeking information about Prostate-Specific Antigen (PSA) testing. Current policies on early detection may also lead to overdiagnosis, underdiagnosis and worsen inequities. More uniform national recommendations could help reduce harm, enhance benefits and ensure a more equitable approach to prostate cancer screening.

Q: Looking ahead, what future developments do you anticipate will have a positive impact on early detection of prostate cancer?

A: There are many approaches to improving early detection of prostate cancer, and risk-stratified screening based upon an individual’s specific risk factors is likely to have a significant positive impact. By incorporating factors such as a man’s age, family/genetic history, PSA-level and overall health, along with using tools such as risk calculators, other biomarkers, and/or magnetic resonance imaging (MRI) before proceeding to prostate biopsy, we can better tailor screening and further clinical work-up to individual needs and reduce unnecessary interventions.

Q: How have health literacy and racial disparities played a role in early detection rates of prostate cancer?

A: Health literacy is crucial for understanding medical information and engaging in shared decision-making, especially in the context of prostate cancer screening. It is essential to optimize decision aids, that help patients make health care decisions, for culturally and linguistically diverse populations to ensure they are effective. Racial disparities in prostate cancer care are noticeable at every stage, driven by structural, socio-environmental, health and biological factors. Addressing these disparities is critical to improve health outcomes. In the U.S., Black men face the highest risk of being diagnosed with and dying from prostate cancer. Our recent collaboration with the Prostate Cancer Foundation led to the development of a prostate cancer screening guideline specifically for Black men, reflecting the need for tailored approaches in addressing these disparities.

Joining Dr. Carlsson on our expert panel is Kelvin Moses M.D., Ph.D., Associate Professor of Urologic Surgery and director of the Comprehensive Prostate Cancer Clinic at Vanderbilt University Medical Center. Dr. Moses also serves on the Board of Directors and Medical Advisory Board for ZERO Prostate Cancer, and is a clinical expert in prostate cancer, including screening. Moderating the event will be ZERO’s Chief Mission Officer, Brian Bragg, M.Sc, who will facilitate this discussion with his 20+ years of experience as a leader in improving health disparities and access to quality health care. Drs. Moses and Carlsson serve on the National Comprehensive Cancer Network Guidelines for Early Detection of Prostate Cancer.

Be sure to join us next week to learn more about the advances in prostate cancer screening and guidelines.