Skip to Main Content

An official website of the United States government

Improved PSA Screening Using Risk Stratification

Principal Investigator
Name
Mark Preston
Degrees
MD, MPH
Institution
The Brigham and Women's Hospital, Inc.
Position Title
Associate Surgeon in Urology
Email
About this CDAS Project
Study
PLCO (Learn more about this study)
Project ID
PLCO-825
Initial CDAS Request Approval
Sep 14, 2021
Title
Improved PSA Screening Using Risk Stratification
Summary
PSA screening has been shown in some studies to reduce mortality from prostate cancer. However, the practice is controversial due to the risk of over-diagnosis and over-treatment. The vast majority of men with latent prostate cancer will never become clinically symptomatic or die from their disease. Smarter screening strategies are required in order to increase the accuracy of identifying men at risk for developing advanced (those with higher stage, metastases or death) prostate cancer while minimizing harms. PSA screening as currently utilized is limited due to its low specificity. One strategy for improving PSA screening is measurement of a baseline PSA during midlife in order to risk-stratify future screening intensity. We have preliminary data supporting this strategy and aim to further improve PSA screening models through decreased testing intensity (thereby reducing overdiagnosis), additional patient characteristics (BMI, comorbidities, medications), and blood markers (existing).
Aims

- Develop a risk stratified screening strategy based on PSA level during midlife and patient characteristics and existing biomarkers.
- Identify which men are at low risk of aggressive prostate cancer and can stop screening.
- Identify a subset of men at higher risk who should have PSA testing beyond age 70.

Collaborators

Quoc-Dien Trinh
Adam Kibel

Related Publications