Moonshot Initiative Funds Study on PSA-Based Risk-Stratified Prostate Cancer Screening - Siobhan Sutcliffe

May 20, 2024

Diane Newman interviews Siobhan Sutcliffe about a project funded as part of the White House Moonshot Initiative. This project aims to gather more data to support PSA-based risk-stratified screening for prostate cancer. By using a man's PSA value, the research seeks to determine whether he might develop clinically significant prostate cancer that could potentially shorten his lifespan. The study involves analyzing PSA readings and specimens from the Kaiser Permanente Northern California Integrated Health System and the Multiphasic Health Checkups Study, which began in the 1960s. This five-year study includes a diverse cohort, providing insights into various populations, including non-Hispanic black, Hispanic, and Asian men. The project hopes to tailor screening regimens based on baseline PSA, offering personalized care and potentially reducing the risk of fatal prostate cancer.


Siobhan Sutcliffe, PhD, ScM, MHS, Professor of Surgery, Mary Culver Department of Surgery, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO

Diane K. Newman, DNP, ANP-BC, BCB-PMD, FAAN, Adjunct Professor of Urology in Surgery, Perelman School of Medicine, University of Pennsylvania, and Former Co-Director of the Penn Center for Continence and Pelvic Health, Philadelphia, PA

Read the Full Video Transcript

Diane Newman: Welcome. I'm here with a colleague of mine, Professor Siobhan Sutcliffe, who's actually at Washington University in St. Louis. She's going to talk to us about a really exciting project that she's beginning, which is part of the White House Moonshot research, correct? Talk to us a little bit about what you're doing.

Siobhan Sutcliffe: Right, so this is a very exciting new project. It was just funded last year, as you said, as part of the Moonshot Initiative. The goal of this grant is to better understand or get more data to support PSA-based risk-stratified screening. Let me take a moment to explain that. The idea is we can take a man's PSA value—so already lots of men are being tested for PSA—and that determines whether they will go for further investigations and whether they have prostate cancer or not.

But the idea here is that a man's PSA value can tell us quite a bit of information about whether they will develop what we call clinically significant prostate cancer in the future. Are they going to develop a prostate cancer that might potentially shorten their lifespan?

Let's say at middle age, if somebody has a lower value of PSA, this man might be a good candidate for less frequent screening. Maybe by the time they get to about 60 years, if their PSA is still low, they might be able to stop because they have a very, very low risk of fatal prostate cancer.

Whereas if a man has not a PSA yet of four, but maybe he has a PSA above an average man's PSA, he might be a good candidate for screening more often and to continue screening past the age of 60. Basically, it's tailoring the screening regimen for each man based on his baseline PSA.

Diane Newman: Well, where are you getting these PSA readings from? Where are you getting the specimens?

Siobhan Sutcliffe: We're getting them from two places. We are going to be working with my colleague, my co-PI on this grant, Dr. Marvin Langston. He was formerly at Kaiser Permanente in Northern California. We'll be using their data, Kaiser Permanente, Northern California Integrated Health System data for some of the analysis.

We're also going to be using specimens and data from a cohort study that was begun in that system in the 1960s, the Multiphasic Health Checkups Study. As part of that study, participants were asked if they could bank some of their blood for research purposes, and this has been used for various different studies over the years, but some of those specimens are still available. We will test those specimens to see whether PSA measured in those specimens is predictive of prostate cancer mortality decades later.

Diane Newman: What is the cohort? Is it a mix of different races? What are the populations you'll be studying?

Siobhan Sutcliffe: Right, so that's one of the really nice features of this study that we're doing. A lot of the work that has been done in this area so far has been done with cohorts from Scandinavia, where the population is largely non-Hispanic white. One really nice feature of this study is it's based in California. There's a much higher percentage of men who are non-Hispanic black, as well as Hispanic, as well as Asian, so lots of different populations in whom we don't have as good data.

Diane Newman: This is a five-year study, right?

Siobhan Sutcliffe: This is a five-year study, yes.

Diane Newman: This is really, really exciting, so that maybe we can see what happens over time as far as with these PSAs and these men, correct?

Siobhan Sutcliffe: Definitely, so we have on some of these men, we have up to five decades of follow-up.

Diane Newman: Oh, wow. That's exciting. Well, thank you so much for sharing that with us. I really appreciate you talking to our viewers about this. Thanks.

Siobhan Sutcliffe: Thank you for inviting me, Diane.