Moment: Why Prostate Cancer Screening Is More Confusing Than Ever

Summary

Podcast Summary: "Should You Get a PSA Test? It’s More Complicated Than You Think"

Podcast: Rena Malik, MD Podcast
Episode: Moment: Should You Get a PSA Test? It’s More Complicated Than You Think ft. Leading Prostate Cancer Surgeon
Release Date: March 25, 2026
Guest Expert: Dr. Scott Egnor (Prostate Cancer Surgeon)
Host: Dr. Rena Malik

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Episode Overview

This episode tackles the nuanced, often confusing landscape of prostate cancer screening via PSA (Prostate-Specific Antigen) testing. Dr. Rena Malik and leading prostate cancer surgeon Dr. Scott Egnor break down who should consider screening, the risks of over-diagnosis, interpreting PSA results, advances in testing, and the realities of managing low-grade prostate cancers. The key theme: there is no one-size-fits-all answer. Individual risk, life expectancy, and controversy around PSA testing make this one of medicine’s most complex topics. Listeners are empowered to make informed, shared decisions about screening and care.

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Key Discussion Points & Insights

1. The Complex PSA Screening History and Its Consequences

• Prostate cancer screening has saved lives but also caused harm through over-diagnosis and over-treatment.
  • Dr. Egnor: "Screening in this country has led to fewer men dying from prostate cancer... about a 50% lower likelihood on an age adjusted mortality level... But there's a much higher likelihood that you got unnecessarily tortured by screening." ([01:15])
• The medical community’s approach has vacillated from universal screening to sharp pullback after the US Preventive Services Task Force initially "derecommended" PSA, leaving confusion and inconsistent practices.
  • Dr. Malik: "The challenge is people are scared of cancer... a lot of people changed their mind about PSA screening... or just screen everybody every year because they don't have the time." ([03:49])

2. Who Should Get Screened and When?

• Risk stratification is key. Higher-risk groups (family history, African American men, BRCA mutation carriers) should discuss screening starting from age 40–55.
  • Dr. Egnor: "If you choose to be screened somewhere between age 40 and 55, you should get a baseline PSA based on your risk factors... We should risk stratify screening." ([01:15])
• Frequency of screening and when to stop:
  • Guidelines often cite age 69 as the upper limit based on European trial data, but "there are 69-year-olds... where it would be crazy to screen them... I'm very comfortable screening men in their 70s or even early 80s if they're really healthy and gonna live a while." ([06:11])
  • Screening should be tailored to life expectancy, not just age.

3. Shared Decision Making & Patient Autonomy

• Importance of patient-physician dialogue rather than blanket protocols.
  • Dr. Malik: "It is supposed to be a shared decision making process... do you want to be screened for cancer? And you can talk about it till you're blue in the face, but usually the answer is yes." ([07:37])
  • Many patients want ongoing screening out of fear, but physicians should discuss real risks, life expectancy, and downstream consequences.

4. What Happens After an Elevated PSA?

• Stepwise approach before biopsy is vital.
  • Initial workup includes digital rectal exam (DRE) — though evidence suggests it only adds value when PSA is above 3.
    • Dr. Egnor: "If you really want to be a scientist and beholden to the data, there's really not a measurable benefit until the PSA is greater than 3." ([09:12])
    • DRE helps assess prostate size, which is crucial for interpreting PSA results.
  • Other causes of PSA elevation (benign prostatic hyperplasia, infection, inflammation) must be excluded—often by repeating the test later and checking additional markers (like percent free PSA).
    • Dr. Egnor: "If you have an elevated PSA, there are many things that can cause that... almost always you just repeat it a couple months later. You don't need antibiotics." ([11:49])

5. The New Biomarker and Imaging Landscape

• Numerous advanced blood, urine, and imaging tools are available (Prostate Health Index, 4K, selectMDx, ExoDx, MRI). These tests aim to clarify risk and minimize unnecessary biopsies.
  • Dr. Egnor: “The intent is to try to identify the ones that may warrant further evaluation... while simultaneously minimizing the number of men that need unnecessary biopsies, or are unnecessarily diagnosed with wimpy prostate cancer.” ([13:40])
• MRI use is growing: Can reduce the number of unnecessary biopsies and overdiagnosis of low-risk cancers. MRI findings can be targeted with fusion technology for biopsy, but “cognitive” targeting can be equally effective in skilled hands and doesn’t require expensive equipment.
  • Dr. Egnor: "The comparative data and even randomized data suggests [cognitive fusion] probably works just as well as the expensive technology." ([17:48])

6. Biopsy Innovations

• Standard practice for localized disease remains needle biopsy—preferably transperineal (through the skin, lower infection risk), not transrectal.
  • Dr. Egnor: "The yield from a cancer detection standpoint appears to be pretty similar, but the benefit is... a measurable lower chance of infection with transperineal..." ([16:20])
• MRI-guided (“fusion”) biopsies help target areas of concern and reduce overdiagnosis of indolent tumors.

7. De-Emphasizing "Wimpy" (Low-Grade) Cancers

• Major change: Most Grade Group 1 (Gleason 6) “cancers” are biologically insignificant and should be monitored, not treated.
  • Dr. Egnor: “We now know with near certainty that monitoring these Gleason 6 or Grade Group Ones is absolutely the right thing to do... It literally cannot cause symptoms, spread, or kill somebody.” ([21:09], [22:32])
  • In the U.S., about 60% are managed with surveillance, but 40% still receive unnecessary treatment.

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Notable Quotes & Memorable Moments

• The Double-Edged Sword of Early Screening:
  • "We saved a lot of lives. We also tortured millions of men." — Dr. Egnor ([01:15])
• Advocating for Individualized Care:
  • "Screening someone in their low 70s or low 80s is wildly different in your goals and how you manage things than a 55 year old healthy person." — Dr. Egnor ([06:11])
• Overtreatment and the Push for Change:
  • "It’s really disturbing... 40% of men diagnosed [with low-grade cancer] go have treatment that they probably didn’t need at that point in time." — Dr. Egnor ([23:26])
• A Reassuring Message:
  • "I'm not aware of a human in history who's had a symptom, metastasis or death from modernly graded grade group 1 or Gleason 6 prostate cancer." — Dr. Egnor ([22:32])
• The Patient Experience:
  • "Once you get on the screening train... you sometimes, you know, the train's left the station and sometimes it's, you know, literally saving their life... and sometimes you wish you could kind of put the train in reverse because you end up doing a lot of testing and there's not a lot of there there." — Dr. Egnor ([08:26])

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Timestamps for Key Segments

• The benefits and harms of PSA screening: [01:15]
• Guidelines for who and when to screen: [01:15]–[06:11]
• When to stop screening, and why: [06:11]
• Downstream consequences of a positive screen: [07:37]
• Digital rectal exam controversy: [09:12]
• Stepwise approach after elevated PSA: [11:49]
• Biomarkers and MRI discussion: [13:40]–[14:55]
• Modern biopsy techniques and fusion: [16:20]–[17:48]
• Understanding and managing low-grade (Gleason 6) cancers: [20:10]–[23:26]

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Take-Home Messages

• PSA screening can save lives but also leads to overtreatment—nuanced, tailored conversations with your physician are critical.
• Not all prostate cancers need to be treated; most low-grade (Grade Group 1/Gleason 6) tumors should be watched, not treated.
• Use of advanced biomarkers and imaging reduces unnecessary biopsies and treatments.
• Screening recommendations should be based on risk factors and health status—not just age.
• Shared, informed decision making is essential: use reputable online resources (e.g., American Cancer Society, Prostate Cancer Foundation) and seek urological input for individualized care.

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For more detailed discussion and evidence-based guidance, listen to the full episode.

Transcript

[Host]

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[Dr. Scott Egnor]

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[Host]

Let's talk about screening a little bit. I think you talked about PSA and let's tell people, you know, how often should they be screening? There are obviously guidelines and then if they're at high risk, like the things you mentioned, like brca, African American family history, when should they start, how often should they get it and when should they stop?

[Dr. Scott Egnor]

Yeah, all great things that could be standalone topics. Again, it would be so great if it was simple, easy, kind of a catchphrase. But there's to individualize things and to do it in a smart, sensible way. There's always layers and complexity. So number one is knowing your baseline risk that we alluded to. Second is deciding whether you want to be screened or not. Unequivocally, screening in this country has led to fewer men dying from prostate cancer. And the great news is even before we got better medications for advanced disease, there's about a 50% lower likelihood on an age adjusted mortality level going down. Basically 50% fewer men dying from prostate cancer. That's a massive win. We should shout it from the rooftops. The problem which you're well aware of is there's a much higher likelihood that you got unnecessarily tortured by screening. Unnecessarily diagnosed, treated and may get exposed to potential side effects for the rest of your life and history kind of comes alive. You can't tell the story without knowing our history. And the history was PSA came around. This early screening mechanism will save all these lives. Everyone should get one. Everyone should do it the same way. Starting at a certain age, get it every year, almost never stop. And we saved A lot of lives. We also tortured millions of men. We are in such a better place now because we have more information. We've transformed things, but there's still a lot of work to do. So as best as possible answering some of your questions there average risk or higher risk, men should absolutely have a conversation with their physician on whether they wanna be screened or not. And there's online tools. Cause it can be complicated. It's not just a simple yes or no. But if you choose to be screened somewhere between age 40 and 55, you should get a baseline PSA based on your risk factors and your baseline psa. And I try to teach our trainees to know what median PSAs are for each decade. We should risk stratify screening. So this kind of, you know, everyone get a PSA every year doesn't make a lot of sense. We need to do what the colorectal, you know, colonoscopists do to screen for that disease based on your risk and your baseline psa. Come back in a year, come back in two years, come back in four years. And this is embedded in many of the guidelines. And then based on that, there's next steps that we can walk through and ultimately talk about when to stop as well.

[Host]

I find that. Well, obviously PSA screening is something that we are very used to, but I find that in the general primary care, they don't have a lot of time to go through this process. There's a lot of, I think, challenging misinformation about psa because as you know very well, the US Preventive Task Force at some point gave PSA screening a D grade meaning, like they should not recommend it, which changed. But based on that, a lot of people change their mind about PSA screening and still don't have all the information or they just screen everybody every year because they don't have the time. So I think for the average person, if they want to be proactive, should they go and look at these? Are there places where they can find these tools and we can link them in the description? Obviously.

[Dr. Scott Egnor]

Yeah, it's a great point and worth emphasizing. And I think we need to shine the light on ourselves. The medical community kind of screwed up. Prostate cancer screening. I'd like to think it was well intentioned in many places it was. But you know, this screening everybody indiscriminately led to plenty of harm. And what ends up happening with this derecommendation is dialing it back. And the kind of reality for most patients is they just go to the doctor and the doctor, the primary care doc, is either soured on PSA screening or is all in and says yes or no. There are good resources through the American Cancer Society, the Prostate Cancer foundation, there's interactive resources, there's true shared decision making tools that are out there. I mean, I can tell you there's not a topic in medicine I feel more comfortable with. I have a lot of expertise in it. And voting with my own feet. I'm a 52 year old man and I check my PSA. So kind of voting with my own feet. I do think there's value to it.

[Host]

Yeah, I think it's very complicated. And I think that the challenge is people are scared of cancer. Right. And so when you. One of the things that I do want to really touch on is we often talk about stopping PSA screening at some point. And so the guidelines would say 69 would be when you could stop PSA screening. And that comes from median age, life expectancy, which is 75 for the average man in the U.S. and so nobody wants to really face their idea of when they're gonna die. And so when you talk about this with patients, they're like, no, I just wanna keep getting screened. So how do you talk to your patients about this?

[Dr. Scott Egnor]

Yeah, I think it's the common theme of our talk. There's always more layers and nuances to it. So the reason 69 is often the high end is the largest trial that showed a benefit to prostate cancer screening was in Europe, where they took data from a bunch of different countries, bundled it together, but the inclusion Criteria was age 55 to 69. It lowered the likelihood of dying from prostate cancer by roughly 25%. So 69, true to the data, was the upper edge. Now here's where all the nuance comes in. So the curves start diverging. There's a couple trials that have shown a benefit. The best are out of Scandinavia, there's European data, but the death rates start converging about eight years after enrolling. But they start diverging. I'm sorry, not converging. Diverging at about eight years. So in general, you don't wanna screen someone unless you're fairly confident they're gonna live 10, 12, 15 plus years. There are 69 year olds, there are 59 year olds where it would be crazy to screen them because it's really unlikely they're gonna live a while. I am very comfortable screening men in their 70s or even early 80s if they're really healthy and gonna live a while. Now screening someone in their low 70s or low 80s is wildly different in your goals and how you manage things than a 55 year old healthy person without any medical issues. But I do think there's potential value there.

[Host]

Yeah, I think the challenge becomes like, it is supposed to be a shared decision making process. And so you're asking someone, hey, do you want to be screened for cancer? And you can talk about it till you're blue in the face, but usually the answer is yes. And so the challenge then becomes, okay, you screen them because you did your job, you tried your best to explain the data, they still said yes. You do your screening, it comes back with an elevated psa, and now you're faced with another checkpoint. Like, do I go ahead with another test? Do I go ahead with an mri? Do I go ahead with a biopsy? And what do I do if those things come back positive? And I think people are like, I'll be fine. Everyone thinks I'll be fine. I'll deal with the data as it comes. But it does lead to this significant anxiety, this significant stress and these risks.

[Dr. Scott Egnor]

Potentially phenomenal points. There's a lot to unpack there. But once you get on the screening train, you sometimes, you know the train's left the station and sometimes it's, you know, literally saving their life, which is the ultimate goal of it. And sometimes you wish you could kind of put the train in reverse because you end up doing a lot of testing and there's not a lot of there there. Or you diagnose a cancer that the patient may or may not benefit from knowing about.

[Host]

So let's talk about when you get an elevated psa. What are the next steps for someone? Should they be getting a digital rectal exam? That's actually another question I have. So there's evidence, at least in the family medicine literature, that we don't need to do digital rectal exams anymore. What are you teaching your trainees and what do you think is appropriate?

[Dr. Scott Egnor]

Yeah, an aha moment for me is when we took a deep dive into the data for one of these guideline committees to put it out there. And if you look at the dre, the digital rectal exam, which is the finger feeling the prostate, if you really want to be a scientist and beholden to the data, there's really not a measurable benefit until the PSA is greater than 3. Now, kind of outside that data, circling back to something we talked about in everyone I'm screening, I do like to do a prostate exam. It's very low yield. To feel a cancer, it can happen. And those are the anecdotes that get a lot of stories. I put my finger in and I found a cancer that I think was really helpful to diagnose the person, but way more common is I want to get a sense of the size of the prostate. And this gets back to the BPH or no bph, you know, do they have a small, medium, large, extra large, or 2xL prostate? Because that goes into interpreting the PSA or what's called the PSA density. And I will make dramatically different, you know, decisions and give them different advice depending on the size of their prostate and their PSA level.

[Host]

Yeah, I agree with that completely. And I think for me, I mean, there's a lot of data that can be garnered from a prostate exam. The tone of their pelvic floor, the, you know, is there tenderness? You know, again, how big is the prostate? And those really do play a role into many symptoms they may be experiencing outside of, you know, just screening. Yeah, especially when they're the urologist. And speaking of, are there symptoms that

[Dr. Scott Egnor]

people should be looking out for for prostate cancer? There are, but almost always by the time you have those symptoms, you've got an advanced cancer. I think it's great when guys come to see the urologist because they have new urinary symptoms, because they're getting evaluated. I find it great that they're sitting there and addressing it. And it's really reassuring for me to tell them your urinary symptoms. It's almost a never event that it's from prostate cancer, even though the fear of prostate cancer is what's brought them into the office. But then at least we can work on quality of life, addressing their urinary symptoms, decide whether they want to get screened for prostate cancer and other things. But yes, if you're having terrible urinary symptoms from prostate cancer, it's usually advanced. And obviously, if it's been metastatic and you're having symptoms throughout your body, it's treatable, but not curable.

[Host]

Yeah, yeah. I think that's the biggest take home for so many people, is there's a reason we do screening is because there are no symptoms, often, most of the time. So once you have a high PSA and say you, you've examined their prostate, you think there's a concern for prostate cancer. What are the next steps?

[Dr. Scott Egnor]

Yeah, there's a lot of steps along the way, and there's different ways that different urologists approach it. Step one, for me, with my patients, there's a lot of cheap, easy, reassuring things that you just take it stepwise. So, as I explained to them, I want to feel their prostate, I want to know their age and risk factors, I want to know their total psa, which is what we've talked about. There's another extraordinarily valuable, easy piece of information called the free psa, which almost every laboratory in our country has available. It's an inverse relationship to prostate cancer risk. So you want your percent free PSA to be high rather than low. If you have an elevated psa, there are many things that can cause that. It can be a large prostate, it can be a wimpy cancer, it can be a real cancer, it can be inflammation, it can be an infection, which is why almost always you just repeat it a couple months later. You don't need antibiotics. That's harmful rather than helpful. There's randomized trials on that. If you think you have an infection, you treat the infection, but you prove it first. You gather all that data. If after all that data and the repeat PSA, there's still something worth paying attention to, then the next steps are there's ancillary blood and serum tests, blood serum or urine tests that you can get and we can go through some of those, or what some people do is get an mri.

[Host]

So, yeah, let's talk about those ancillary tests, because there are so many at this time commercially available biomarker tests that you can do at that time of pre biopsy. And so I think for the average person, you know, they go to the urologist and they just expect the urologist will do all the things that are available to them, but there's so many, and I think that the average urologist probably can't keep up with all the different genomic tests. So which ones do you think are the most helpful in this situation?

[Dr. Scott Egnor]

Yeah, so this space is really busy and it's, and it's really good news that there's six to eight tests out there. Probably the most common ones are called Prostate Health Index 4K, select MDX, ExoDx. There's some investigational ones in Europe, Stockholm 3. And then there's others, ISOPSA. They all have potential value. There's various costs, there's various ease of use and the science behind them is all positive. And what the intent is to try to identify the ones that may warrant further evaluation, to capture the diagnoses that you're looking for while simultaneously minimizing the number of men that need biopsies, need unnecessary biopsies, or are unnecessarily diagnosed with wimpy. Prostate cancer that they probably didn't even need to know about. So those are all kind of the secondary biomarker space.

[Host]

Yeah. And then do you think that now. So MRI wasn't a part of PSA or prostate cancer diagnosis in the pathway till very recently. I would say probably like a decade, less than a decade. Is there value still in doing those tests over getting an mri?

[Dr. Scott Egnor]

Yeah, no one really knows for sure. So I can tell you, all those biomarkers we just talked about have value. MRI has value. There are people who use both of them. There's people who use one versus the other, and there's people who still use neither of them. There's an ongoing trial in Sweden where they're trying to integrate those into each other. But as standalone, MRI also has value. And in a very simplistic way, the way I like to explain it to a patient, getting an MRI is a form of a biomarker. You get a picture of the prostate, It's a good picture, often a very good picture, but rarely perfect. And it's important to know with any test, particularly MRI of the prostate, you know, you can have false alarms. So just because an MRI shows something or suggests something doesn't necessarily mean it's worrisome. And it also depends on the quality of the MRI pictures, who's reading it. So it can get, you know, complicated pretty quickly.

[Host]

Yeah. So these are all tools that you can use but don't necessarily have to. So let's talk about the next step, which would say, say you did some of these or did not. Either way, you're now still concerned about a prostate cancer. The next step would be a biopsy. And so biopsy has also changed over the last decade or more. Let's talk about what is the innovation in this phase? What should patients ask for when they're getting their biopsy?

[Dr. Scott Egnor]

Yeah, Nowadays and in the near future, the standard way of getting diagnosed with localized prostate cancer is a biopsy. There's some provocative data out there that maybe will get to the point one day with next generation imaging or what's called PSMA PET scan, that maybe it'll be so darn good that you don't have to stick needles in the prostate. But nowadays, 99% of people in the United States, that's the way they're diagnosed with localized disease. There's many ways of accessing the prostate and getting needles in there. The two most common are going through the rectum or going through the skin. That's between the scrotum in the rectum, which is called the perineum. So it's transperineal or transrectal. Back to randomized trials, which is what we're always thirsty for, to help inform things. It's still considered standard ish to do either transrectal or transperineal. Although the country and other parts of the world with our level of technology are moving pretty aggressively towards transperineal. The last five plus years, I've never referred someone for a transrectal. It's transperineal. The yield from a cancer detection standpoint appears to be pretty similar, but the benefit is there is either a measurable lower chance of infection with transperineal or pretty similar to transperineal or transrectal, although you need fewer antibiotics with transperineal. So there's probably a measurable benefit there.

[Host]

And then in terms of people who get an mri, there's also fusion biopsies. So there's different types of fusion biopsies, right?

[Dr. Scott Egnor]

Yeah.

[Host]

And so what should they. Are there specific types of fusions that are better than others?

[Dr. Scott Egnor]

A great question. And there's kind of a good news, bad news story to that. So there's a load of studies, including many randomized studies, that if you get an MRI prior to your biopsy, there's measurable benefit. And I always think of it as a, as a triple win. You basically can identify the same number of men with grade group 2 or higher, prostate cancer, kind of the cancers we're looking to diagnose. Fewer men need a biopsy, 20 to 50% fewer men need a biopsy if you get good news on your mri. And the third thing, the trifecta is you diagnose fewer men with grade group one or Gleason six, which I think is very beneficial. Now, again, it really depends on the quality of your mri, the fusion technology in the US at least, fusion technology is taking a suspicious lesion on mri, marrying it to an ultrasound image. And when you take your biopsy, you put those needles towards the target and you want to sample that area or around that area to try to be higher yield. Now, that's done with fancy, often expensive technology. And that's largely good news and an advancement. The downside to it is we might also be diagnosing more men with cancer who don't necessarily need to know about it. And the data that doesn't, you know, really run the clinics these days is you probably don't always need the fancy technology. It's called cognitive fusion, which is basically, oh, the MRI Shows or suggests an abnormality in the left upper part of the prostate. We don't need this fancy technology. But I know enough with my ultrasound. I'll just send some extra biopsies into that left upper part. And the comparative data and even randomized data suggests it probably works just as well as the expensive technology.

[Host]

That's good news. Yeah, that's great news, because I think, you know, I mean, us aside, other countries can't necessarily afford that kind of technology. So if they can get mri that does. I mean that then they have one less expensive thing to worry about. So you've mentioned wimpy cancers, Gleason grade 1 cancers. Let's explain a little bit about what sort of cancers, what result you would get from biopsy, and how you would characterize that as wimpy or really concerning cancer.

[Dr. Scott Egnor]

Yeah. The way I think about it and explain it to any patient I refer to a biopsy is to try to keep it easy for them to understand, but also accurate is I recommend a biopsy. After the biopsy, your results is going to fall into one of three categories. What we're hoping for is no cancer. Hallelujah. The second category is you're going to be diagnosed with a cancer, but it's small, wimpy, and almost assuredly we will just monitor that. But the third possibility, and the only reason we're having this discussion and you're going for a biopsy, is in case we find a cancer that might warrant attention and treatment. And we'll have a long conversation about the laundry list of potential treatment options for that type of cancer.

[Host]

And that's a change because this lower grade or gleason grade six cancer, these used to be treated universally. And so tell us how we've sort of veered from treating everyone to now watching patients.

[Dr. Scott Egnor]

Yeah, this gets back to kind of the early psa days. You know, you have a test that can find all these cancers. Finding cancer early, war on cancer must be better. You know, find it early, treat aggressively. So when I was a resident and even fellow, the most common surgery we did was a Radical prostatectomy for Gleason 6 prostate cancer, which is now called in some circles, grade group one. Through some iconoclastic pioneers in Canada and the United States and even in Europe, they came to understand that we can monitor a lot of these. And like most things that are disruptive, it was contentious and controversial and heated debates. And we now know with near certainty that monitoring these Gleason 6 or grade group ones is absolutely the right thing to do. And that's why it's preferred management in every single guideline on this planet for these early stage wimpier ones. Now, the next step that myself and many others think, we have a whole movement of trying not to diagnose these things. Okay, you don't want to diagnose people with Grade group one because you don't think it's going to benefit them even knowing about it. These biomarkers we talked about, one of the benefits that are advertised appropriately. So is not diagnosing Grade group one mri. One of the benefits is not. And so we're saying, even if you get diagnosed with grade group one, let's call it something else, and I could give you a long winded, very boring soliloquy on it. But on a very basic level, if you just go to the dictionary of what is cancer and what is Benign? Grade Group 1 prostate, quote unquote, cancer fits the criteria of something that's benign. It literally cannot cause symptoms, spread, or kill somebody. And until someone proves me otherwise, I will stand up in front of any audience and say, I'm not aware of a human in history who's had a symptom, metastasis or death from modernly graded grade group 1 or Gleason 6 prostate cancer.

[Host]

That's really powerful. I think that's really important for people to hear because there are still many urologists treating grade group 1 or Gleason 6 cancer with surgery and radiation who likely will not need it.

[Dr. Scott Egnor]

Hell yeah. And it's really disturbing and it really bothers me to no end in other countries around this planet, like Australia, England, Sweden, and dare I say, even more civilized from a prostate standpoint. More than 90, even 95% of people diagnosed with grade group one go on surveillance, which is probably the benchmark of where it should be in our country. Nationwide, the latest data we have is at 60%. So to your point, 40% of men diagnosed with this for one reason or another, and there's many potential reasons, go have treatment that they probably didn't need at that point in time. Now, we do highlight in the United States a remarkably impressive cooperative group or collective. It's something called music in Michigan, where they made an effort to improve the quality of prostate cancer care. And in the state of Michigan, their surveillance rates parallel those of some other countries. We need to try to do that elsewhere, and we're making incremental progress. It just hasn't been as fast as we'd like.

[Host]

If you like that episode with Dr. Scott Egnor, make sure to check out the full episode right here.

[Dr. Scott Egnor]

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