Dr. Eggener on PSA-Based Screening in Early-Stage Prostate Cancer

Scott Eggener, MD, associate professor of Surgery, Urologic Oncology, at the University of Chicago Medicine, discusses his views on prostate-specific antigen (PSA)-based screening and how to appropriately use it for patients with early-stage prostate cancer. Eggener shared these thoughts during the 2016 OncLive State of the Science Summit on GU and Prostate Cancer.

Smart PSA-based screening is able to reduce the risk of mortality, Eggener explains. However, PSA-based screening can often lead to overdetection and overtreatment of patients who are unlikely to benefit from it. This is a constant controversy surrounding early prostate cancer treatment. Therefore, it is important to use this approach widely, to identify patients who have a reasonable life expectancy, are well informed, are interested in PSA screening, and can be biopsied appropriately, he says.

Moreover, active surveillance may prove to be an appropriate option for many patients with low-risk prostate cancers who do not require treatment. However, Eggener adds, treatment is both necessary and likely beneficial in patients who have intermediate- or high-risk disease.

In addition, novel screening biomarkers, such as tissue-based biomarkers that have sufficient evidence, are proving to be advances to the field of prostate cancer. The upcoming—and current—challenge is how to integrate them appropriately into the standard care pathways, given their increasing cost, Eggener adds.