Affiliation:
1. Department of Urology Skåne University Hospital Malmö Sweden
2. Division of Urological Cancers, Department of Translational Medicine Lund University Malmö Sweden
3. Department of Medical Imaging and Physiology Skåne University Hospital Malmö Sweden
4. Division of Diagnostic Radiology, Department of Translational Medicine Lund University Malmö Sweden
5. Department of Clinical Pathology and Molecular Diagnostics Medical Services Malmö Sweden
6. Department of Urology, Institute of Clinical Sciences Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden
7. Department of Surgery (Urology Service) Memorial Sloan Kettering Cancer Center New York NY USA
8. Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York NY USA
Abstract
ObjectiveTo determine the feasibility of a digitally automated population‐based programme for organised prostate cancer testing (OPT) in Southern Sweden.Patients and MethodsA pilot project for a regional OPT was conducted between September 2020 and February 2021, inviting 999 randomly selected men aged 50, 56, or 62 years. Risk stratification was based on prostate‐specific antigen (PSA) level, PSA density (PSAD), and bi‐parametric prostate magnetic resonance imaging (MRI). Men with a PSA level of 3–99 ng/mL had an MRI, and men with elevated PSA level (≥3 ng/mL) had a urological check‐up, including a digital rectal examination and transrectal ultrasonography (TRUS). Indications for targeted and/or systematic transrectal prostate biopsies were suspicious lesions on MRI (Prostate Imaging‐Reporting and Data System [PI‐RADS] 4–5) and/or PSAD > 0.15 ng/mL/mL. Additional indications for prostate biopsies were palpable tumours, PSA ratio < 0.1, or cancer suspicion on TRUS. Patient selection, mail correspondence, data collection, and algorithm processing were performed by an automated digital management system. Feasibility is reported descriptively.ResultsA total of 418 men had a PSA test (42%), with increasing participation rates by age (50 years, 38%; 56 years, 44%; and 62 years, 45%). Among these, 35 men (8%) had elevated PSA levels (≥3 ng/mL: one of 139, aged 50 years; 10/143, aged 56 years; and 24/146, aged 62 years). On MRI, 16 men (48%) had a negative scan (PI‐RADS < 3), seven men (21%) had PI‐RADS 3, nine men (27%) had PI‐RADS 4, and one man (3%) had PI‐RADS 5. All men with PI‐RADS 4 or 5 underwent prostate biopsies, as well as two men with PI‐RADS 3 due to PSAD > 0.15 ng/mL/mL or a suspicious finding on TRUS. Prostate cancer was diagnosed in 10 men. Six men underwent active treatment, whereas four men were assigned to active surveillance.ConclusionOur OPT model is feasible from an operational point of view, but due to the limited scale of this study no conclusions can be made regarding the efficacy of the diagnostic model or outcome.
Funder
National Institutes of Health
Prostate Cancer Foundation
Cited by
1 articles.
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