Do MRI-targeted prostate biopsies lead to over-diagnosis and over-treatment??!!

Well the data are clear, says eminent biostatistician and research methodologist, Dr Andrew Vickers of Memorial-Sloan Kettering Cancer Centre in New York. In some well constructed recent articles, Andrew has really made us think again about the impact of  moving to MRI-directed triage and targeted biopsies, instead of "blind" systematic biopsies. Could it be that this strategy actually leads to harm, rather than the clear benefits which many assume that MRI has brought to prostate cancer diagnostics??We are joined today by Andrew, and two household names in the world of MRI-targeted biopsies to defend the practice (which is now recommended by all major guidelines). Professor Caroline Moore, Urologist at University College London, and Dr Veeru Kasivisvanathan, Urology Fellow at Peter MacCallum Cancer Centre in Melbourne. Veeru and Caroline were first and senior authors on the landmark  PRECISION trial published in NEJM in 2018 which led to the adoption of MRI in early detection of prostate cancer. And Dr Renu Eapen  is back from her travels and in her usual co-hosting role, along with Professor Declan Murphy. Plus Dr Aoife McVey returns to tell us what caught her eye on twitter this week. A cracking episode! Also posted on Youtube hereLinks:Dr Andrew Vickers TwitterProfessor Caroline Moore Twitter Dr Veeru Kasivisvanathan TwitterDr Aoife McVey Twitter@Urology_tips TwitterDr Laura Bukavina TwitterAndrew's recent European Urol article on the harms of MRI-targeted biopsies ($)Renu's ASCO GU talk