New model improves prediction of prostate cancer death risk

Embargoed for release until 5:00 p.m. ET on Monday 12 January 2026   

Follow @Annalsofim on X, Facebook, Instagram, Bluesky, and Linkedin             
Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.   
----------------------------    

1. New model improves prediction of prostate cancer death risk

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-02036

URL goes live when the embargo lifts             

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 tool, tested on over 200,000 men, outperformed current methods and could help doctors tailor screening and treatment decisions based on individual risk and life expectancy. The findings are published in Annals of Internal Medicine.  

To improve how PSA test results are interpreted, researchers from the University of Michigan used long-term data from over 33,000 men aged 55-74 in a major U.S. cancer screening trial to build a novel prognostic model and validated their findings in a separate group of nearly 175,000 Veterans Affairs patients in the same age range. They 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 to existing models, the new tool showed higher accuracy in predicting prostate cancer death over decades, suggesting it could guide more personalized screening and treatment decisions. The authors note that the development of this tool represents a key step in the movement toward reducing overtreatment and improving personalized care in this space and has potential real-world application to the nearly 10 million patients who undergo prostate cancer screening each year.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Patrick Lewicki, MD, MS please email lewickip@med.umich.edu. 

----------------------------   

2. Study finds 17% of patients are perceived as difficult by physicians

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-01882

Editorial: https://www.acpjournals.org/doi/10.7326/ANNALS-25-05280

URL goes live when the embargo lifts             

A systematic review of 45 studies found that physicians perceive one in six patient visits in non-psychiatric clinics as “difficult,” and these encounters are more likely to involve patients with mental health disorders or chronic pain. The analysis also found that less experienced providers report more difficult interactions, and these visits often leave patients less satisfied and with unmet expectations. The review is published in Annals of Internal Medicine.

Researchers from Clement J. Zablocki Veterans’ Administration Medical Center and Medical College of Wisconsin sought to understand how often clinic visits are considered difficult and what factors contribute to these challenging interactions. They conducted a systematic review and analysis of studies of adult patients seen in nonpsychiatric settings that included information on the prevalence, characteristics, or outcomes of patients perceived as difficult or characteristics of the physicians who considered them difficult. The analysis showed that about 17% of patients were perceived as difficult. Patients with depression, anxiety, chronic pain, substance use disorders, or personality disorders were significantly more likely to fall into this category. Providers with fewer years of experience also reported more difficulty. Provider characteristics that increased the prevalence of difficult clinic visits included provider experience, burnout, and job satisfaction. Patients were more likely to leave difficult clinic visits with unmet expectations and lower satisfaction. The findings suggest that improving training for nonpsychiatric physicians so they could better address underlying mental health and pain issues could make visits more productive and positive for both patients and clinicians.  

In an accompanying editorial, editorialists discuss how the review has provided an important map of where and with whom difficulty tends to arise and say that the next step is to use that map not to avoid these patients, but to be better prepared for caring for them.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Jeffrey L. Jackson, MD, MPH please email jjackson@mcw.edu. 

----------------------------   

Also new this issue:

Iron Deficiency Anemia

Kylee L. Martens, MD and Thomas G. DeLoughery, MD

In the Clinic 

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-04416