Objective:

To compare the effectiveness of the Stockholm3 test with conventional PSA screening in detecting clinically significant prostate cancer.

Approach:

• Study Design: Population-based study involving 12,670 men aged 50 to 74 years in the Stockholm region, analyzing data from the STHLM3-MRI screening trial.
• Test Comparison: Stockholm3 combines PSA measurements with genetic, protein, and clinical risk factors, compared against age-based PSA thresholds.

Key Findings:

• Stockholm3 detected 90% of clinically significant prostate cancers (400 out of 443) compared to 74% for PSA ≥3 ng/ml and 52% for PSA ≥4 ng/ml.
• False-positive rates were similar for Stockholm3 and PSA ≥3 ng/ml (11% vs 10%), while PSA ≥4 ng/ml had a lower false-positive rate of 5%.
• Stockholm3 referred more men for additional diagnostic assessments and had lower specificity than age-based PSA thresholds.

Interpretation:

Limitations:

• The study was a secondary analysis of the baseline screening round of the STHLM3-MRI randomized trial.

Conclusion:

Sources:

• Annals of Internal Medicine