– Sophisticated screening methods are needed to reduce overdiagnosis and over-treatment of low-risk tumors and to prevent unnecessary cancer diagnoses and side effects, says Martin Eklund, senior lecturer in the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet, co-responsible for sthlm3mr nauka.
The results of the sthlm3mr study show that overdiagnosis is halved when traditional prostate tissue sampling is replaced by magnetic resonance imaging (MRI) and targeted tissue samples. The number of unnecessary tissue samples that identify harmless small tumors is reduced, while the new method detects an equally large number of dangerous tumors.
Unnecessary information about prostate cancer
Randomised study involving participants from the Stockholm district, which was conducted between 2018 and 2021 and includes 12,750 men. Participants first submitted a blood sample for PSA analysis and analysis of the new Stockholm3 test, developed by scientists from Karolinska Institutet. Men with elevated test scores were then referred for traditional tissue sampling or MRI. In the MRI group, tissue samples were taken only if suspicious tumours were detected in the MRI scan.
Further research was carried out on how to combine the Stockholm3 test with MRI to further improve the screening method for prostate cancer.
Additional blood test
“We will soon be presenting exciting results to see if additional blood testing can reduce the need for MRI scans in the future and make diagnosis even more difficult. Future prostate cancer diagnosis will likely consist of a combination of both blood tests and MRI. For a long time, Sweden has been conducting national screening for breast and cervical cancer in women.
Our results from several large clinical trials involving a total of more than 70,000 men provide evidence that men can also reduce the risk of serious cancer through national prostate cancer screening with modern methods, says Tobias Nordström.
The findings will be presented at eau21 (9 July), Europe’s largest urological congress organised by the European Urological Association (eau), where clinicians, researchers and patients meet in a virtual environment. At the same time the results are published in the New England Journal of medicine.
“The eau is working hard to ensure that early detection of prostate cancer is included in the implementation of the European Cancer Action Plan to reduce mortality in the most common male cancers in Europe, while tackling the challenges of overdiagnosis and over-treatment. We really can’t wait to see how sthlm3mr can continue to contribute to this goal, he continues.