Combination Of MRI And New Blood Test May Improve Prostate C
The addition of a novel blood test, the Stockholm3 test, to the MRI-targeted biopsy approach for prostate cancer screening can reduce overdetection whilst maintaining the ability to detect clinically significant cancer, show researchers at Karolinska Institutet in Sweden. In the recent study, they showed that the addition of the Stockholm3 test can reduce the number of MRIs performed by a third while further preventing the detection of minor, low-risk tumors.

Current screening methods – PSA (prostate-specific antigen) tests combined with traditional biopsies – result in unnecessary biopsies and the detection of numerous minor, low-risk tumors (overdiagnosis). Consequently, no country except Lithuania has chosen to introduce a nationwide prostate cancer screening program, as the benefits do not outweigh the disadvantages.

On July 9, 2021, results from the STHLM3MRI study were presented in The New England Journal of Medicine, indicating that overdiagnosis could be reduced by substituting traditional prostate biopsies with magnetic resonance imaging (MRI) and targeted biopsies. The new results, now published in The Lancet Oncology, show that the addition of the Stockholm3 test, which was developed by researchers at Karolinska Institutet, can be an important complement.

It is a blood test that uses an algorithm to analyze a combination of protein markers, genetic markers and clinical data. "The availability of MRI in healthcare will be a limiting factor. We now show that a novel blood test as an adjunct to MRI can reduce the number of MRIs performed by a third. Compared with traditional screening, overdiagnosis is reduced by as much as 69 percent. At the same time, the number of biopsies is halved, while we can find just as many clinically significant tumors", says Martin Eklund, associate professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, with joint responsibility for the STHLM3MRI study.

STHLM3MRI is a randomized study that was conducted between 2018 and 2021 with 12,750 male participants from Stockholm County. The participants provided an initial blood sample for PSA analysis and analysis using the new Stockholm3 test. Men with test results showing elevated PSA levels were then randomly selected for traditional biopsies or MRI. In the MRI group, biopsies were conducted strictly on suspected tumors identified by MRI.

"Separate use of the Stockholm3 test and MRI has previously been shown to be cost-effective. We have now analyzed the cost-effectiveness when these tools are combined and will shortly report exciting results from that analysis," the researcher concludes.

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