The Next Generation of Prostate Cancer Screening

Despite the fact that approximately one in eight men will face a prostate cancer diagnosis, the current standard of screening—the Prostate-Specific Antigen (PSA) test—presents challenges for patients and the healthcare system.

In an interview with The Pathologist, Dr. Jason Hafron, Chief Medical Officer at the Michigan Institute of Urology, outlines his vision for improving diagnostics. While PSA screening has proven life-saving by reducing mortality, its major flaw is poor specificity, often leading to overdiagnosis and overtreatment. The test frequently results in false positives, causing anxiety and unnecessary biopsies for up to 75% of men without high-grade disease.

Dr. Hafron emphasizes that interpreting PSA must be refined by considering factors like age, race, and family history, and by adopting age-adjusted cutoffs for PSA levels rather than the traditional 4 ng/mL threshold.

The key to improvement lies in using advanced biomarkers and imaging before resorting to a biopsy. Guidelines now recommend utilizing tools like IsoPSA and Multi-Parametric MRI (mpMRI), which provide a more accurate risk assessment for clinically significant disease. Integrating biomarkers like IsoPSA with MRI results can greatly improve the negative predictive value, helping clinicians confidently rule out high-grade cancer and avoid unnecessary procedures.

Although adoption barriers remain, the future diagnostic pathway should involve a comprehensive, AI-driven risk assessment that combines demographics, genetics, imaging, and biomarker results to personalize the screening approach for every patient.

Read Dr. Hafron’s complete interview with The Pathologist.