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Innovation, Education Critical to Optimizing Early Detection in Prostate Cancer

Laura Panjwani
Published: Wednesday, Feb 03, 2016

E. David Crawford, MD

E. David Crawford, MD

The US Preventive Services Task Force (USPSTF) recommends against routine PSA-based screening for prostate cancer, citing concern for unnecessary and potentially harmful biopsies, surgery, and radiotherapy.

, he explains his view of the current role for PSA testing in prostate cancer and the need for continued innovation and advancement with new screening technologies.

OncLive: How has the use of PSA as a screening tool for prostate cancer risk changed over the years?

Crawford: A number of years ago, I was involved in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, a large population-based randomized trial designed to determine the effects of screening on cancer-related mortality.

During that trial, I looked at a group of men stratified by their initial PSA and what happened to them during the 7 to 10 years of the trial. From that study, it was very obvious that if patients had a PSA of less than 1, their risk of having a PSA go above 4—the cutoff for biopsy—was around 0.3%. At the time, we presented our belief that if we follow the rule that if PSA is less than 1, then patients should come back in 5 years, and we could save the healthcare system 0 million to billion.
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