Clinical Scorecard: Stockholm3 Test Cuts MRIs in Prostate Screening

At a Glance

Key Highlights

• Stockholm3 test significantly reduced MRI scans in prostate cancer screening.
• MRI use fell from 2.7% to 1.1%, a 60% relative reduction.
• Biopsy rates declined from 0.6% to 0.4% with Stockholm3 implementation.
• Cancer detection rates were similar between control and experimental groups.
• Stricter reflex-testing further reduced testing demand while maintaining cancer detection.

Guideline-Based Recommendations

Diagnosis

• Use Stockholm3 as a reflex test after PSA for men with PSA ≥ 2 ng/mL.

Management

• Recommend MRI only if Stockholm3 score is at least 15.

Monitoring & Follow-up

• Evaluate the need for MRI and biopsy based on Stockholm3 results.

Risks

• Potential for lower cancer detection rates with reduced imaging.

Patient & Prescribing Data

Men with PSA levels of 2 ng/mL or higher.

Multi-marker blood tests can optimize imaging resource use.

Clinical Best Practices

• Implement Stockholm3 testing to triage MRI referrals.
• Consider stricter reflex-testing strategies to further reduce unnecessary procedures.

References

• European Association of Urology Congress