A new long-term prediction tool estimates the risk of dying from prostate cancer, offering a more accurate way to interpret prostate-specific antigen (PSA) test results compared to existing models.
The new tool, a prognostic model for risk for prostate cancer-specific mortality (PCSM) after a PSA test, tested on more than 200,000 men, outperformed current methods and could help physicians tailor screening and treatment decisions based on individual risk and life expectancy.
The findings are published in the January 13, 2026, edition of Annals of Internal Medicine.[1]
Improving interpretation
To improve the interpretation of PSA test results, researchers from the University of Michigan used long-term data from more than 33,000 men aged 55-74 in a major U.S. cancer screening trial to develop a novel prognostic model and validated their findings in a separate cohort of nearly 175,000 Veterans Affairs patients in the same age range.
The researchers built a model that predicts the likelihood of dying from prostate cancer by combining PSA levels with factors like family history, race, age, and other health conditions.
Compared with existing models, the new tool demonstrated higher accuracy in predicting prostate cancer mortality over decades, suggesting it could inform more personalized screening and treatment decisions.
Overtreatment
Overtreatment of prostate cancer has been recognised as a public health concern that largely undermines prostate cancer screening efforts. [2] Hence, the authors note that the development of this tool represents a major step toward reducing overtreatment and improving personalized care in this area, and it has potential real-world application for the nearly 10 million patients who undergo prostate cancer screening each year.
Study limitation
Given the period under study, the authors caution that the model may not be generalizable to contemporary PSA screening methods.
Reference
[1] Lewicki P, Jiang R, Radhakrishnan A, Bryant A, Schipper M, Morgan TM, Stensland K. Predicting Long-Term Risk for Prostate Cancer Mortality Following a Prostate-Specific Antigen Screening Test: Prognostic Model Development and External Validation. Ann Intern Med. 2026 Jan 13. doi: 10.7326/ANNALS-25-02036. Epub ahead of print. PMID: 41525694.
[2] Monda SM, Demus T, Jaime-Casas S, Meah S, Srivastava A, Sarle R, Labardee C, Ghani KR, Ginsburg KM, Morgan TM, Borza T. Trends in Surgical Overtreatment of Prostate Cancer. JAMA Oncol. 2025 Jul 1;11(7):700-706. doi: 10.1001/jamaoncol.2025.0963. PMID: 40292607; PMCID: PMC12038712.
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