Grant Number:	1U01CA319220-01 Interpret this number
Primary Investigator:	Etzioni, Ruth
Organization:	Fred Hutchinson Cancer Center
Project Title:	Modeling to Support Decisions in an Evolving Landscape of Prostate Cancer Control
Fiscal Year:	2026

Project Summary/Abstract Prostate cancer is the most common solid tumor and the second most common cause of cancer death in men in the United States. Since the inception of the Cancer Intervention and Surveillance Modeling Network (CISNET) the Prostate Working Group (PWG) has led in the development and application of models to interpret changes in the population burden of prostate cancer and inform strategies for disease detection and management. We have traditionally prioritized the most clinically relevant questions regarding prostate cancer management and policy that are not easily addressable via empirical studies but that are amenable to modeling. In this renewal application we will modernize two independently developed, complementary models (FHCC and UMICH) to reflect today’s diagnosis, staging, and treatment landscape. We will extend survival models to incorporate progression to clinical metastasis, quantify how novel systemic therapies and imaging might impact screening benefit, project benefit-harm tradeoffs of advanced imaging scans for disease staging, refine estimates of overdiagnosis to guide primary treatment selection, and evaluate new precision screening approaches incorporating reflex biomarkers and MRI for biopsy referral. This work will also assess implementation options for settings with limited access to reflex tests and investigate criteria for when to stop screening in older men. Our Specific Aims are as follows. Aim 1: Extend models of prostate cancer survival to incorporate progression to clinical metastasis. Project impact of new treatments for metastatic disease and imaging tools for metastasis detection. Aim 2: Estimate efficacy of screening given contemporary primary and post-primary treatment patterns. Aim 3: Estimate harms of screening under contemporary grading systems and screening practices. Aim 4: Evaluate harms and benefits of contemporary and tailored prostate cancer screening strategies. These aims are highly responsive to the funding opportunity, addressing targeted priority areas that are most relevant to prostate cancer control: emerging technologies, precision treatment, informing decisions in real-world settings, and cancer type-specific opportunities. Our cumulative expertise in prostate cancer, our existing models, and our close ties with clinical experts, who will support our analyses of large high-quality datasets, put us in a strong position to answer critical and impactful questions about how best to control this most common cancer in men.





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