New screening tool may detect more dangerous prostate cancers than PSA testing alone

• In a recent study, the Stockholm3 risk assessment tool outperformed PSA alone in detecting clinically significant prostate cancer, identifying 90% of cases compared with 74% detected by traditional PSA screening.
• Specificity was similar across the two approaches, indicating that Stockholm3 improved cancer detection without substantially increasing false-positive rates.
• The multivariable risk tool combines PSA levels with genetic markers, blood-based proteins, and clinical risk factors to provide a more comprehensive assessment of an individual’s prostate cancer risk.
• The findings suggest that risk-based screening strategies could improve the identification of aggressive prostate cancers while helping to limit unnecessary biopsies and follow-up procedures. However, longer-term studies are needed to evaluate the impact on patient outcomes.

Prostate cancer is the second most common cancer in men worldwide, and the second most common cancer in American males. While screening can help identify cancers at an earlier and more treatable stage, experts have long debated the best way to screen for the disease.

The prostate-specific antigen (PSA) blood test has been widely used for decades, but elevated PSA levels do not always indicate cancer. Other factors, such as older age, an enlarged prostate, or prostatitis, can also increase PSA levels, leading to unnecessary imaging, biopsies, and anxiety.

At the same time, PSA screening can miss some aggressive cancers that require treatment. As such, researchers continue to investigate whether combining PSA with additional risk factors could improve the accuracy of screening.

Now, a new study suggests that a multivariable screening test, known as Stockholm3, may identify significantly more clinically important prostate cancers than the traditional PSA blood test alone.

Published in the Annals of Internal Medicine, alongside a patient summary, the findings note that the tool detected 90% of clinically significant prostate cancers, compared with 74% detected through PSA screening alone, while maintaining a similar ability to avoid false-positive results.