Skip to content

Stockholm3 validated in repeat screening for prostate cancer

A new article, published in European Urology Oncology highlights the effectiveness of Stockholm3 in improving repeat screening for prostate cancer. The clinical study demonstrated that using Stockholm3 instead of traditional prostate-specific antigen (PSA) testing increased detection of clinically significant cancers by 31%, without increasing the need for magnetic resonance imaging.

The original, population-based screening-by-invitation randomized STHLM3-MRI (1) trial included over 12,000 men aged 50–74. Two to three years after the initial round, 2,000 men with PSA 1.5 ng/ml at trial inclusion, who were randomized to magnetic resonance imaging (MRI)-enhanced screening and not diagnosed with prostate cancer, were invited to repeat screening involving analysis of PSA and Stockholm3.

Results showed (2) that using Stockholm3 for repeat prostate cancer screening led to a 31% higher sensitivity for detection of clinically significant cancers, with an equal number of MRIs at a Stockholm3 cut-off of ≥11.

“Three-quarters of all prostate cancer testing is repeat testing, meaning that the man has been tested before and is now returning for the second, third, or fourth time. It is therefore crucial that the diagnostic tools used are validated for repeat testing,” Associate Professor Tobias Nordström said in a comment.

“Increasing our understanding of how to design repeat testing is essential for developing a reliable prostate cancer screening program. Our study shows that Stockholm3 significantly improves detection of aggressive prostate cancer without increasing the number of MRIs, in initial as well as repeat testing,” Tobias Nordström concluded.

The study reinforces the role of Stockholm3 in repeat screening settings, by improving detection rates for clinically significant cancers, reducing unnecessary procedures and optimizing resource utilization.

(1) Discacciati, A., Abbadi, A., Clements, M. S., Annerstedt, M., Carlsson, S., Grönberg, H., Jäderling, F., Eklund, M., & Nordström, T. (2024). Repeat Prostate Cancer Screening using Blood-based Risk Prediction or Prostate-specific Antigen in the Era of Magnetic Resonance Imaging-guided Biopsies: A Secondary Analysis of the STHLM3-MRI Randomized Clinical Trial. European urology oncology, S2588-9311(24)00244-X. Advance online publication. https://euoncology.europeanurology.com/article/S2588-9311(24)00244-X/fulltext

(2) Nordström, T., Discacciati, A., Bergman, M., Clements, M., Aly, M., Annerstedt, M., Glaessgen, A., Carlsson, S., Jäderling, F., Eklund, M., Grönberg, H., & STHLM3 study group (2021). Prostate cancer screening using a combination of risk-prediction, MRI, and targeted prostate biopsies (STHLM3-MRI): a prospective, population-based, randomised, open-label, non-inferiority trial. The Lancet. Oncology22(9), 1240–1249. https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00348-X/abstract