Stacy Loeb, MD, discusses the evolving landscape of prostate cancer screening

In an interview at the 2025 LUGPA Annual Meeting, Stacy Loeb, MD, shared key takeaways from her session, “Current state of prostate cancer screening.” Loeb is a urologists at NYU Langone Health in New York, New York.

During the discussion, Loeb highlights several important updates shaping today’s approach to prostate cancer screening. A key change comes from the AUA, which now recommends offering men a baseline PSA test between ages 45 and 50, aligning with NCCN guidelines.

Loeb also notes the growing shift toward risk-adapted screening, which tailors screening intervals based on a patient’s individual risk profile. This includes traditional factors such as African ancestry, family history, and high-risk genetic variants like BRCA, as well as PSA itself as a risk indicator.

When comparing guidelines, Loeb says that there is strong alignment around the importance of shared decision-making. However, she does acknowledge several differences, particularly in biopsy recommendations. US guidelines still support either transrectal or transperineal approaches, whereas European guidelines now favor the transperineal method. There is also some variation in how strongly MRI is recommended, though the speaker stresses that MRI has been one of the most transformative tools in modern prostate cancer screening, improving both risk assessment and biopsy accuracy.