PD38-11 THE STOCKHOLM3 PROSTATE CANCER SCREENING TRIAL (STHLM3): AN INTERIM ANALYSIS OF MORTALITY RESULTS AFTER 6.5 YEARS OF FOLLOW-UP

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD38-11 THE STOCKHOLM3 PROSTATE CANCER SCREENING TRIAL (STHLM3): AN INTERIM ANALYSIS OF MORTALITY RESULTS AFTER 6.5 YEARS OF FOLLOW-UP Chiara Micoli, Alessio Crippa, Andrea Discacciati, Thorgerdur Palsdottir, Hari Vigneswaran, Markus Aly, Jan Adolfsson, Johan Lindberg, Peter Wiklund, James Thompson, Yvonne Brandberg, Mark Clements, Lars Egevad, Henrik Grönberg, Tobias Nordström, and Martin Eklund Chiara MicoliChiara Micoli More articles by this author , Alessio CrippaAlessio Crippa More articles by this author , Andrea DiscacciatiAndrea Discacciati More articles by this author , Thorgerdur PalsdottirThorgerdur Palsdottir More articles by this author , Hari VigneswaranHari Vigneswaran More articles by this author , Markus AlyMarkus Aly More articles by this author , Jan AdolfssonJan Adolfsson More articles by this author , Johan LindbergJohan Lindberg More articles by this author , Peter WiklundPeter Wiklund More articles by this author , James ThompsonJames Thompson More articles by this author , Yvonne BrandbergYvonne Brandberg More articles by this author , Mark ClementsMark Clements More articles by this author , Lars EgevadLars Egevad More articles by this author , Henrik GrönbergHenrik Grönberg More articles by this author , Tobias NordströmTobias Nordström More articles by this author , and Martin EklundMartin Eklund More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003336.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate cancer screening is controversial due to high rates of overdiagnosis. The population-based screening trial STHLM3 utilized a single prostate-specific antigen (PSA) and Stockholm3 test (a prediction model based on clinical variables, blood biomarkers, and a polygenic risk score) to identify Gleason score ≥7 prostate cancer. In an interim analysis after 6.5 years of follow-up, we compared prostate cancer specific and all-cause mortality in men invited to STHLM3 to men not invited. METHODS: STHLM3 was conducted 2012-2015. Men 50-70 years of age residing in Stockholm, Sweden, were randomly invited from the general population to undergo prostate cancer testing. Men with PSA ≥3 ng/ml or Stockholm3 ≥10% were recommended prostate biopsy. We calculated cumulative incidences and risk ratios (RR) of prostate cancer diagnosis, prostate cancer mortality, and any-cause mortality after 6.5 years of follow-up in men invited to STHLM3 vs. not invited (intention-to-screen analysis). Alpha spending adjusted two-sided 98% confidence intervals were computed. RESULTS: In total, 245,905 men were eligible for STHLM3; 168,707 (69.6%) were randomly invited and 70,297 (29.4%) were not invited. Of invited men, 58,909 (35%) participated and 109,798 (65%) did not.After 6.5 years of follow-up, 91 men died of prostate cancer among men invited to STHLM3 vs. 51 among men not invited (RR 0.76; 98% CI 0.50 to 1.14). The number of prostate cancer diagnoses was higher among men invited to STHLM3 (n=5310) vs. not invited (n=1742) (RR 1.21; 98% CI 1.15 to 1.29). For all-cause mortality, there were 7784 deaths among men invited to STHLM3 vs. 3189 deaths among men not invited (RR 1.03; 98% CI 0.98 to 1.08). CONCLUSIONS: These results may cautiously suggest a potential effect on reducing prostate cancer mortality after 6.5 years of follow-up by a single intensive screening intervention using PSA and Stockholm3 in combination, to the cost of increased prostate cancer incidence. Longer-term follow-up is needed and is underway. Source of Funding: Swedish Research Council, Swedish Cancer Society © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e997 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chiara Micoli More articles by this author Alessio Crippa More articles by this author Andrea Discacciati More articles by this author Thorgerdur Palsdottir More articles by this author Hari Vigneswaran More articles by this author Markus Aly More articles by this author Jan Adolfsson More articles by this author Johan Lindberg More articles by this author Peter Wiklund More articles by this author James Thompson More articles by this author Yvonne Brandberg More articles by this author Mark Clements More articles by this author Lars Egevad More articles by this author Henrik Grönberg More articles by this author Tobias Nordström More articles by this author Martin Eklund More articles by this author Expand All Advertisement PDF downloadLoading ...