Grant Details
Grant Number: |
5U01CA253915-04 Interpret this number |
Primary Investigator: |
Etzioni, Ruth |
Organization: |
Fred Hutchinson Cancer Center |
Project Title: |
Modeling Precision Interventions for Prostate Cancer Control |
Fiscal Year: |
2022 |
Abstract
PROJECT SUMMARY/ABSTRACT
Prostate cancer is the most common solid tumor in men and the second most common cause of cancer death
in the United States. The Cancer Intervention and Surveillance Modeling Network (CISNET) Prostate Working
Group (PWG) was formed in the year 2000 to address a wide range of questions about effective prostate
cancer control. The PWG studied the rapid increase in prostate cancer diagnoses after PSA screening started
in the late 1980s to estimate lead time and overdiagnosis associated with the test. The PWG studied the
decline in prostate cancer mortality that began in the early 1990s to quantify the plausible contributions of PSA
screening and changes in primary treatments. The PWG also studied how to interpret trends in racial
disparities in incidence and survival, how to manage men with low-risk disease on active surveillance, and how
to reconcile apparently discordant randomized trials of PSA screening and radical prostatectomy.
In recent years, technologies surrounding prostate cancer screening and treatment have evolved rapidly, and
opportunities to improve patient care using personalized data abound. Genetic testing can identify men at
increased risk for developing aggressive disease, new biomarkers and imaging tools can help men avoid
unnecessary biopsies, and new hormonal treatments can lengthen survival for men with advanced disease.
The objective of this application is to extend PWG models to evaluate optimal ways to utilize personalized data
to improve patient care while limiting harms and costs. We will determine whether we can improve early
detection using novel stratification approaches and whether we can safely limit overtreatment and other harms
by tailored choices of primary and secondary therapies. These approaches will be applied in the United States
and in international cancer control settings with different resources and priorities.
Our specific aims are as follows. Aim 1: Precision early detection, including risk-stratified screening and biopsy
using genetic tests, novel biomarkers, and imaging technology. Aim 2: Precision active surveillance, including
adaptive biopsy intervals and imaging technology. Aim 3: Precision treatment, including type and timing of
initial and salvage therapies. Aim 4: Targeting screening, biopsy, and treatment policies to reduce racial
disparities. Aim 5: Prioritizing screening and treatment interventions in international settings. These aims are
highly responsive to the funding opportunity announcement, addressing 7 of the 9 targeted priority areas to
varying degrees. Our cumulative expertise in prostate modeling, our existing models, and our close ties with
clinical experts who provide access to large, high-quality datasets for model validation and calibration put us in
a strong position to answer critical and impactful questions about how best to control this most common cancer
in men.
Publications
Reducing Prostate Cancer Overdiagnosis.
Authors: Gulati R.
.
Source: The New England journal of medicine, 2022-12-08; 387(23), p. 2187-2188.
PMID: 36477037
Related Citations
Cost-Effectiveness Analysis of Prostate Cancer Screening in the UK: A Decision Model Analysis Based on the CAP Trial.
Authors: Keeney E.
, Sanghera S.
, Martin R.M.
, Gulati R.
, Wiklund F.
, Walsh E.I.
, Donovan J.L.
, Hamdy F.
, Neal D.E.
, Lane J.A.
, et al.
.
Source: PharmacoEconomics, 2022 Dec; 40(12), p. 1207-1220.
EPub date: 2022-10-06.
PMID: 36201131
Related Citations
Editorial Comment.
Authors: Gulati R.
, Nyame Y.A.
.
Source: The Journal of urology, 2022 Nov; 208(5), p. 1027.
EPub date: 2022-09-06.
PMID: 36065679
Related Citations
Correction: Estimating patient health in prostate cancer treatment counseling.
Authors: Chesnut G.T.
, Tin A.L.
, Fleshner K.A.
, Benfante N.E.
, Vickers A.J.
, Eastham J.A.
, Sjoberg D.D.
, Carlsson S.V.
.
Source: Prostate cancer and prostatic diseases, 2022 Sep; 25(3), p. 598.
PMID: 35361969
Related Citations
Corrigendum to definitive and sustained increase in prostate cancer metastases in the United States.
Authors: Patel N.A.
, Sedrakyan A.
, Bianco F.
, Etzioni R.
, Gorin M.A.
, Hsu W.C.
, Mao J.
, Nguyen P.L.
, Schaeffer E.
, Shoag J.
, et al.
.
Source: Urologic oncology, 2022 Jul; 40(7), p. 354.
EPub date: 2022-05-30.
PMID: 35654645
Related Citations
Harm-to-Benefit of Three Decades of Prostate Cancer Screening in Black Men.
Authors: Basourakos S.P.
, Gulati R.
, Vince R.A.
, Spratt D.E.
, Lewicki P.J.
, Hill A.
, Nyame Y.A.
, Cullen J.
, Markt S.C.
, Barbieri C.E.
, et al.
.
Source: NEJM evidence, 2022 Jun; 1(6), .
EPub date: 2022-05-15.
PMID: 35721307
Related Citations
Evaluation of Prostate Cancer Screening Strategies in a Low-Resource, High-risk Population in the Bahamas.
Authors: Heijnsdijk E.A.M.
, Gulati R.
, Lange J.M.
, Tsodikov A.
, Roberts R.
, Etzioni R.
.
Source: JAMA health forum, 2022 May; 3(5), p. e221116.
EPub date: 2022-05-20.
PMID: 35977253
Related Citations
Scalable proximal methods for cause-specific hazard modeling with time-varying coefficients.
Authors: Wu W.
, Taylor J.M.G.
, Brouwer A.F.
, Luo L.
, Kang J.
, Jiang H.
, He K.
.
Source: Lifetime data analysis, 2022 Apr; 28(2), p. 194-218.
EPub date: 2022-01-29.
PMID: 35092553
Related Citations
Impact of cancer screening on metastasis: A prostate cancer case study.
Authors: Lange J.
, Remmers S.
, Gulati R.
, Bill-Axelson A.
, Johansson J.E.
, Kwiatkowski M.
, Auvinen A.
, Hugosson J.
, Hu J.C.
, Roobol M.J.
, et al.
.
Source: Journal of medical screening, 2021 Dec; 28(4), p. 480-487.
EPub date: 2021-02-09.
PMID: 33563084
Related Citations
Divining Harm-Benefit Tradeoffs of Magnetic Resonance Imaging-targeted Biopsy.
Authors: Etzioni R.
, Haffner M.C.
, Gulati R.
.
Source: European urology, 2021 Nov; 80(5), p. 573-574.
EPub date: 2021-09-01.
PMID: 34479754
Related Citations
Clarifying the Trade-Offs of Risk-Stratified Screening for Prostate Cancer: A Cost-Effectiveness Study.
Authors: Hendrix N.
, Gulati R.
, Jiao B.
, Kader A.K.
, Ryan S.T.
, Etzioni R.
.
Source: American journal of epidemiology, 2021-10-01; 190(10), p. 2064-2074.
PMID: 34023874
Related Citations
The Impact of Intensifying Prostate Cancer Screening in Black Men: A Model-Based Analysis.
Authors: Nyame Y.A.
, Gulati R.
, Heijnsdijk E.A.M.
, Tsodikov A.
, Mariotto A.B.
, Gore J.L.
, Etzioni R.
.
Source: Journal of the National Cancer Institute, 2021-10-01; 113(10), p. 1336-1342.
PMID: 33963850
Related Citations
Economic Evaluation of Urine-Based or Magnetic Resonance Imaging Reflex Tests in Men With Intermediate Prostate-Specific Antigen Levels in the United States.
Authors: Jiao B.
, Gulati R.
, Hendrix N.
, Gore J.L.
, Rais-Bahrami S.
, Morgan T.M.
, Etzioni R.
.
Source: Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2021 Aug; 24(8), p. 1111-1117.
EPub date: 2021-04-22.
PMID: 34372976
Related Citations
When to Discuss Prostate Cancer Screening With Average-Risk Men.
Authors: Gulati R.
, Carlsson S.V.
, Etzioni R.
.
Source: American journal of preventive medicine, 2021 Aug; 61(2), p. 294-298.
EPub date: 2021-05-06.
PMID: 33966938
Related Citations
Cost-effectiveness of multiparametric magnetic resonance imaging and MRI-guided biopsy in a population-based prostate cancer screening setting using a micro-simulation model.
Authors: Getaneh A.M.
, Heijnsdijk E.A.
, de Koning H.J.
.
Source: Cancer medicine, 2021 Jun; 10(12), p. 4046-4053.
EPub date: 2021-05-15.
PMID: 33991077
Related Citations
Prostate Cancer Screening Guidelines for Black Men: Spotlight on an Empty Stage.
Authors: Etzioni R.
, Nyame Y.A.
.
Source: Journal of the National Cancer Institute, 2021-06-01; 113(6), p. 650-651.
PMID: 33146382
Related Citations
Preoperative exercise interventions to optimize continence outcomes following radical prostatectomy.
Authors: Mungovan S.F.
, Carlsson S.V.
, Gass G.C.
, Graham P.L.
, Sandhu J.S.
, Akin O.
, Scardino P.T.
, Eastham J.A.
, Patel M.I.
.
Source: Nature reviews. Urology, 2021 May; 18(5), p. 259-281.
EPub date: 2021-04-08.
PMID: 33833445
Related Citations
Problems with Numbers in Decision Aids for Prostate-specific Antigen Screening: A Critical Review.
Authors: Carlsson S.V.
, Vickers A.J.
, Gonsky J.P.
, Hay J.L.
, Hu J.C.
.
Source: European urology, 2021 Mar; 79(3), p. 330-333.
EPub date: 2020-12-09.
PMID: 33309033
Related Citations
Surgeon heterogeneity significantly affects functional and oncological outcomes after radical prostatectomy in the Swedish LAPPRO trial.
Authors: Nyberg M.
, Sjoberg D.D.
, Carlsson S.V.
, Wilderäng U.
, Carlsson S.
, Stranne J.
, Wiklund P.
, Steineck G.
, Haglind E.
, Hugosson J.
, et al.
.
Source: BJU international, 2021 Mar; 127(3), p. 361-368.
EPub date: 2020-09-29.
PMID: 32916021
Related Citations
Prostate-Specific Antigen Screening and Recent Increases in Advanced Prostate Cancer.
Authors: Nyame Y.A.
, Gulati R.
, Tsodikov A.
, Gore J.L.
, Etzioni R.
.
Source: JNCI cancer spectrum, 2021 Feb; 5(1), .
EPub date: 2020-10-26.
PMID: 33442662
Related Citations
Assessment of harms, benefits, and cost-effectiveness of prostate cancer screening: A micro-simulation study of 230 scenarios.
Authors: Getaneh A.M.
, Heijnsdijk E.A.M.
, Roobol M.J.
, de Koning H.J.
.
Source: Cancer medicine, 2020 Oct; 9(20), p. 7742-7750.
EPub date: 2020-08-19.
PMID: 32813910
Related Citations
"PSA Surveillance in the Septuagenarian": A Proposed New Terminology for Clinical Follow-up to Assess Risk of Prostate Cancer in Men Aged 70 Years and Older.
Authors: Carlsson S.V.
, Eastham J.A.
, Crawford E.D.
, Harris R.G.
.
Source: European urology, 2020 Aug; 78(2), p. 136-137.
EPub date: 2020-04-06.
PMID: 32273182
Related Citations
Risk of Recurrent Disease 6 Years After Open or Robotic-assisted Radical Prostatectomy in the Prospective Controlled Trial LAPPRO.
Authors: Nyberg M.
, Akre O.
, Bock D.
, Carlsson S.V.
, Carlsson S.
, Hugosson J.
, Lantz A.
, Steineck G.
, Stranne J.
, Tyritzis S.
, et al.
.
Source: European urology open science, 2020 Jul; 20, p. 54-61.
EPub date: 2020-08-19.
PMID: 34337458
Related Citations