New blood test combined with image-based prostate cancer screening
reduces harms and costs

Date:
January 28, 2022
Source:
Karolinska Institutet
Summary:
The combination of a novel blood test and magnetic resonance
imaging (MRI) can reduce overdiagnosis of low-risk cancers as well
as societal costs in prostate cancer screening, according to a
cost-effectiveness study.



FULL STORY ==========================================================================
The combination of a novel blood test and magnetic resonance imaging (MRI)
can reduce overdiagnosis of low-risk cancers as well as societal costs
in prostate cancer screening, according to a cost-effectiveness study
from Karolinska Institutet published in the journal European Urology. The results provide support for organised prostate cancer testing in Sweden, researchers say.


==========================================================================
A barrier to the introduction of nationwide prostate cancer screening has
been that PSA (prostate-specific antigen) tests combined with traditional biopsies result in the detection of numerous minor low-risk tumours. MRI
has been shown to reduce this overdiagnosis but presents a challenge
due to limited health resources. The STHLM3MRI trial has previously
shown that a blood test called Stockholm3, developed by researchers at Karolinska Institutet, can reduce the number of MRIs by a third for a
single screening occasion. Now, the same research group reports that
this combination is also considered cost-effective in Sweden compared
with both no screening and PSA test in MRI-based screening.

Further reduction in MRI "Our latest results show that using Stockholm3
reduces the number of MRIs over a lifetime by 60 per cent. This also
avoids unnecessary biopsies by 9 per cent, which reduces the overdiagnosis
of low-risk cancers," says Mark Clements, associate professor at
the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, who is responsible for the cost- effectiveness study.

The analysis predicted that MRI-based screening combined with PSA or
Stockholm3 would reduce prostate cancer-related deaths by 7-9 per cent
over a lifetime compared with no screening at all. The health economic evaluation showed that, compared with no screening, screening with PSA
followed by Stockholm3 and MRI in high-risk individuals is classified as
a moderate cost per quality-adjusted life-years (QALY) gained as defined
by the Swedish National Board of Health and Welfare. Furthermore, PSA
combined with MRI is classified as a very high cost per QALY gained
compared with Stockholm3 combined with MRI.

"This new combination with Stockholm3 can save healthcare resources and
reduce societal costs while maintaining the health benefits from early detection of prostate cancer. This presents an interesting option for
prostate cancer screening in Sweden," says Shuang Hao, PhD student at
the Department of Medical Epidemiology and Biostatistics, Karolinska
Institutet and the first author of the study.

Support for OPT in Sweden Several regions in Sweden have started to plan
and implement pilot projects for organised prostate cancer testing (OPT) through the regional cancer centres.

The National OPT Working Group has recommended that the OPT pilots
investigate the use of different strategies for prostate cancer screening.

"Our evidence provides support for using Stockholm3 as an additional
test in MRI-based screening, which could be evaluated through one of
the OPT pilots," says Tobias Nordstro"m, associate professor of urology
at the Department of Clinical Sciences, Danderyd Hospital at Karolinska Institutet, who is the principal investigator for the STHLM3MRI trial
and a co-author of the cost- effectiveness study.

Wider application to other countries The current health economic
evaluation is specific to Sweden, but the simulation model used in this
study is open source and can be readily adapted to assess the use of
Stockholm3 and MRI in other countries. The Stockholm3 test is available
for clinical use in Sweden, Norway, Denmark, Finland, Spain and Germany,
and will be made available in additional European countries in 2022.

The research was financed by the Swedish Research Council, the Swedish e- Science Research Centre (SeRC), the Swedish Prostate Cancer Federation, Karolinska Institutet and The Swedish Cancer Society. One of the
co-authors, Henrik Gro"nberg, has five prostate cancer diagnostic-related patents pending.

Another co-author, Martin Eklund, is named on four of these patent applications. Karolinska Institutet collaborates with A3P Biomedical
in developing the technology for the Stockholm3 test. Henrik Gro"nberg,
Martin Eklund and Tobias Nordstro"m own shares in A3P Biomedical.

========================================================================== Story Source: Materials provided by Karolinska_Institutet. Note: Content
may be edited for style and length.


========================================================================== Journal Reference:
1. S. Hao, E. Heintz, E. O"stensson, A. Discacciati, F. Ja"derling, H.

Gro"nberg, M. Eklund, T. Nordstro"m, M. Clements. Cost Effectiveness
of the Stockholm3 Test and Magnetic Resonance Imaging in Prostate
Cancer Screening: A Microsimulation Study. European Urology,
2022 DOI: 10.1016/ j.eururo.2021.12.021 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/01/220128100728.htm

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