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Joseph C. Presti, MD

Joseph  Presti, MD

Joseph Presti, MD, a urologist with The Permanente Medical Group, is an Adjunct Investigator with the Division of Research and a physician researcher with the Delivery Science & Applied Research Physician Researcher Program. Dr. Presti, who specializes in the evaluation and treatment of urologic cancers, has practiced at Kaiser Permanente Northern California (KPNC) since 2012. Previously, he held faculty positions at Stanford University and the University of California, San Francisco. Dr. Presti’s research focuses on refining detection strategies for prostate cancer. His early work investigated biopsy strategies for improving prostate cancer detection. He is now developing and evaluating a risk calculator that uses simple clinical variables to predict a patient’s risk of developing an aggressive prostate cancer. Dr. Presti also studies prostate cancer screening and detection, and he is currently working with the KPNC Department of Adult and Family Medicine to refine their shared decision-making program that aims to maximize benefits and minimize harms from prostate cancer screening. Dr. Presti serves as the co-clinical lead for the National KP Prostate Cancer Screening Guideline Team.

Current Position(s):

Section Affiliations:

Primary Research Interests:

  • Prostate cancer screening and detection
  • Risk stratification for prostate cancer


Improving Shared Decision Making for Prostate Cancer Screening

To create an optimized E-visit by engaging with member stakeholders; and implement a randomized study in select facilities with a revised E-visit that follows a personalized-medicine approach and compares it to the recently activated E-visit.

Investigator: Presti, Joseph

Funder: TPMG Delivery Science Projects Program

Development of the Kaiser Permanente Prostate Cancer Risk Calculator

Much of the controversy surrounding prostate cancer screening is due to the poor predictive value of PSA blood tests and the risks attendant to over-diagnosis. This project aims to develop a risk calculator that uses clinical variables to determine the risk of having prostate cancer, the risk of having high-grade prostate cancer (defined as Gleason scores of 7 to 10), or the risk of having an indolent prostate cancer. A retrospective cohort study of 2000 men who have undergone biopsy at Kaiser Permanente Northern California will be used to generate a predictive model, which will then be validated with data from 1000 additional patients. A detailed comparison with age-specific PSA reference ranges and an existing risk calculator from the Prostate Cancer Prevention Trial will be performed to determine the new model’s clinical utility. The Kaiser Permanente Prostate Cancer Risk Calculator will stratify patients into cancer-risk categories that will better enable both patients and physicians to more accurately determine the need for biopsy.

Investigator: Presti, Joseph

Funder: The Permanente Medical Group


Screening for Prostate Cancer

Authors: Presti, Joseph;Alexeeff, Stacey;Avins, Andrew L

N Engl J Med. 2023 Jul 06;389(1):93-94.

PubMed abstract

Reply by Authors

Authors: Horton, Brandon;Alexeeff, Stacey;Prausnitz, Stephanie;Avins, Andrew L;Presti, Joseph

Urol Pract. 2022 Jan;9(1):71. Epub 2021-12-02.

PubMed abstract

Race-Specific Trends in Prostate Cancer Screening and Presentation before and after the 2012 United States Preventive Services Task Force Statement

Authors: Horton, Brandon;Alexeeff, Stacey;Prausnitz, Stephanie;Avins, Andrew L;Presti, Joseph

Urol Pract. 2022 Jan;9(1):64-71. Epub 2021-12-02.

PubMed abstract

Changes in Prostate Cancer Presentation Following the 2012 USPSTF Screening Statement: Observational Study in a Multispecialty Group Practice

Authors: Presti J; Alexeeff S; Horton B; Prausnitz S; Avins AL

J Gen Intern Med. 2019 Dec 09.

PubMed abstract

The Stockholm-3 (STHLM3) Model can Improve Prostate Cancer Diagnostics in Men Aged 50-69 yr Compared with Current Prostate Cancer Testing

Authors: Eklund M; StLezin M; Grönberg H; et al.

Eur Urol Focus. 2018 09;4(5):707-710. Epub 2016-11-23.

PubMed abstract

A Biopsy-based 17-gene Genomic Prostate Score as a Predictor of Metastases and Prostate Cancer Death in Surgically Treated Men with Clinically Localized Disease

Authors: Van Den Eeden SK; Lu R; Zhang N; Quesenberry CP; Shan J; Han JS; Tsiatis AC; Leimpeter AD; Lawrence HJ; Febbo PG; Presti JC

Eur Urol. 2018 01;73(1):129-138. Epub 2017-10-06.

PubMed abstract

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