At the American Urological Association鈥檚 Expert Convening on , Dr. Matthew Nielsen, Chair of the 黑料网 Department of Urology, member of the Lineberger Comprehensive Cancer Center, and Chair of the AUA鈥檚 Science and Quality Council, delivered a keynote segment titled 鈥淎dvancing Diagnostic Excellence in Prostate Cancer.鈥� His presentation built on years of cross-disciplinary leadership and role as a national thought leader in prostate cancer care improvement.
The summit, held in October 2024, focused on improving the quality and consistency of prostate MRI as a critical diagnostic tool. Dr. Nielsen鈥檚 remarks framed the conversation within a broader call for system-level change, centered on patient outcomes, equity, and collaboration across specialties.
A National Voice on Diagnostic Excellence
For Dr. Nielsen, the pursuit of diagnostic excellence is not just a clinical issue, it is a defining challenge in modern healthcare. Quoting the Journal of the American Medical Association, he emphasized that an accurate and precise diagnosis 鈥済ains clinical value insofar as it leads to better choices in treatment.鈥�
This principle underpins his work as Chair of the AUA鈥檚 Science and Quality Council, where he has helped shape the , prioritizing health equity, imaging stewardship, and the reduction of diagnostic variation. He also serves on the National Quality Forum鈥檚 (NQF) Diagnostic Excellence Committee, where he contributes to policy development and quality standards across medical specialties.
In 2023, Dr. Nielsen was named a National Academy of Medicine (NAM) Scholar in Diagnostic Excellence, one of only ten physicians selected nationally. His project focuses on integrating quality metrics into diagnostic workflows for patients with elevated PSA, a central theme echoed throughout the AUA summit and his continued work at 黑料网.
Addressing Prostate Cancer Disparities and the PSA Screening Challenge
In his QI Summit talk, Dr. Nielsen emphasized the urgent need to improve care across the entire diagnostic continuum, from PSA screening and MRI to biopsy, surveillance, and treatment.
Central to his message was addressing racial disparities in prostate cancer diagnosis and outcomes:
- Black men are 1.8 times more likely to be diagnosed, and 2.4 times more likely to die from prostate cancer compared to White men. Given the high prevalence of prostate cancer, this accounts for听
- While incidence rates dropped significantly between 2007 and 2014, they have been rising again, especially for advanced-stage disease.
Dr. Nielsen underscored the importance of patient-tailored PSA screening protocols and better utilization of high-quality prostate MRI to stratify risk and avoid both overtreatment and missed opportunities for early intervention.
“Diagnostic excellence doesn鈥檛 just happen in the clinic, it requires collaboration across radiology, primary care, and urology, and a shared commitment to equity. If we want to close the gap in outcomes, we must first close the gap in access to timely, reliable diagnosis.”
Dr. Nielsen has spoken extensively on this topic, see his remarks on prostate cancer and health equity here.
A Platform for Progress: From Policy to Practice
Dr. Nielsen鈥檚 message at the AUA QI Summit emphasized that advancing diagnostic excellence requires collaboration across every stage of the prostate cancer care continuum. From PSA screening to imaging, biopsy, and treatment, each step offers an opportunity to improve quality, reduce delays, and tailor care to individual patient needs.
He underscored that MRI plays a central role in this process. When performed with high quality, prostate MRI can:
- Improve detection of cancers that require treatment,
- Avoid unnecessary biopsies and the detection of low-risk disease,
- And help stratify patients more effectively based on clinical risk.
Achieving these benefits, however, depends on consistent image quality and appropriate use, areas where variation remains a significant challenge.
Dr. Nielsen highlighted that diagnostic excellence is not just about making the right diagnosis, it鈥檚 about ensuring the process is timely, cost-effective, understandable, and clinically meaningful. This means not only improving technology and protocols, but also fostering stronger collaboration between radiologists, urologists, primary care providers, and patients.