Time: Wed 21.5. klo 15-16
Topic: A randomised pragmatic population-based trialof prostate cancer screening (ProScreen)
Speaker: Anssi Auvinen, Prof. and Director of the Prostate Cancer Research Center, MD., Ph.D., Tampere University
This time the webinar is organized by FICAN Mid. The seminar will be heldonline (Microsoft Teams) and is open to everyone interested in cancer research.
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Meeting ID: 384 919 436 576 Passcode: eP3LW3TyAuvinen
Abstract:
We have shown in the ERSPC trial that PSA-based screening can reduce prostate cancer mortality, but due to extensive overdiagnosis of low-risk cases, the balance of benefits and harms is questionable.
We have designed a screening protocol aimed at minimising overdiagnosis, but maintaining the mortality impact. The screening intervention consist of three tests, provided in a stepwise fashion: First PSA, for men with PSA3 ng/ml also a kallikrein panel (4Kscore) and if it exceeds 7.5%, a referral to MRI. Men with a suspicious MRI findings (PI-RADS score 3–5) are referred to targeted prostate biopsy.
We have randomised 113,357 men aged 50–63 from Helsinki and Tampere metropolitan areas, with a quarter allocated to screening and the rest to the control arm.
Results from the first screening round show that large majority (80%) of the screen-detected cases are high-grade cancers (ISUP grade group 2–5). Compared with the control arm, one additional high-grade cancer was detected per 200 men, while the excess of low-grade cases (grade group 1) was considerably smaller (one excess case per 800 men).
Relevat references for this talk:
- Bratt O, Auvinen A, Godtman AR, ym. Screening for prostate cancer. BMJ Oncol 2023;2:e000039
- Auvinen A, Tammela T, Mirtti T, et al. Prostate cancer screening with PSA, kallikrein panel and MRI: The ProScreen randomized trial. JAMA 2024;331:1452-59
- Rannikko A, Leht M, Mirtti T, ym. Population-based randomized trial of screening for clinically significant prostate cancer: A pilot study. BJU Int 2022;130:193-199
