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  • Bratt, Ola,1963Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology (author)

Population-based Organised Prostate Cancer Testing: Results from the First Invitation of 50-year-old Men

  • Article/chapterEnglish2024

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  • 2024

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  • LIBRIS-ID:oai:gup.ub.gu.se/332570
  • https://gup.ub.gu.se/publication/332570URI
  • https://doi.org/10.1016/j.eururo.2023.11.013DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:238042646URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:155440979URI

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  • Language:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Background: The European Union recently recommended evaluation of the feasibility of organised prostate cancer screening. In Sweden, regional population-based organised prostate cancer testing (OPT) programmes were introduced in 2020. Objective: To describe initial participation rates and diagnostic outcomes. Design, setting, and participants: The three most populated Swedish regions invited all men aged 50 yr to OPT by a letter in 2020–2022. Men with prostate-specific antigen (PSA) ≥3 ng/ml were referred for prostate magnetic resonance imaging (MRI). PSA assays differed across regions. Men with Prostate Imaging Reporting and Data System (PI-RADS) 1–3 and PSA density ≥0.15 ng/ml/cm3 or PI-RADS 4–5 were referred for a biopsy. Data were obtained from the Swedish Register for Organised Prostate Cancer Testing. Outcome measurements and statistical analysis: Overall and regional participation rates, PSA distributions, PI-RADS score distributions, cancer detection, and treatment were evaluated. Results and limitations: A total of 23 855 (35%) of 68 060 invited men participated; 696 (2.9%) had PSA ≥3 ng/ml, and of them, 306 (44%) had a biopsy indication and 221 (32%) had a biopsy. On biopsy, 93 (42%) had Gleason grade group ≥2 (0.39% of PSA-tested men) and 44 (20%) Gleason grade group 1 cancer. Most men with cancer had treatment with curative intent (70%) or were under active surveillance (28%). Across regions, proportions of men with PSA ≥3 ng/ml ranged from 2.3% to 4.0%, and those with PI-RADS score 4–5 ranged from 12% to 21%. A limitation is that results are applicable only to first testing of men in their early 50s. Conclusions: The OPT programmes are feasible with good compliance to the diagnostic pathway. The use of MRI and PSA density avoided a biopsy for over half of the men with PSA ≥3 ng/ml. Inter-regional differences in diagnostic outcomes show a need for standardisation of the diagnostic pathway's components. Patient summary: We report the diagnostic outcomes of inviting 68 000 50-yr-old men to organised prostate cancer testing.

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  • Godtman, Rebecka Arnsrud,1981Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology(Swepub:gu)xgodre (author)
  • Jiborn, Thomas (author)
  • Wallström, JonasGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology (author)
  • Akre, OlofKarolinska Institutet (author)
  • Carlsson, StefanKarolinska Institutet (author)
  • Nordström, TobiasKarolinska Institutet (author)
  • Thimansson, Erik (author)
  • Alterbeck, Max (author)
  • Zackrisson, Sophia (author)
  • Hugosson, Jonas,1955Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology(Swepub:gu)xhugjo (author)
  • Bjartell, Anders (author)
  • Lantz, AnnaKarolinska Institutet (author)
  • Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för urologi (creator_code:org_t)

Related titles

  • In:European Urology85:3, s. 207-2140302-28381873-7560

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