Andrew Vickers, PhD, Memorial Sloan Kettering Cancer Center, New York City, NY, discusses the limitations of using polygenic risk scores (PRSs) to risk-stratify PSA-screening. An important consideration when developing screening programmes is the ‘net benefit’ of lives saved vs. factors such as the cost of screening and overdiagnosis. For prostate cancer, an effective screening programme would need to use a marker that doesn’t just predict incidence but also predicts mortality. Dr Vickers concludes that stratifying the population and only screening those at high-risk will only be effective if the marker used is better at predicting mortality than incidence. This interview took place at the American Urological Association annual congress 2022 in New Orleans and online.