Finding aggressive prostate cancer earlier

Prostate cancer is the most common cancer in men. Stockholm3 can find aggressive prostate cancer earlier.

90 000+


Participants in clinical studies [1]

41-89%


More aggressive cancers found [2]

37-52%


Fewer unnecessary biopsies [3]

8-28%


Lower healthcare costs [4]

Prostate cancer is the most common cancer in men and the second leading cause of cancer-related deaths.


Early detection plays a key role in the effective treatment and cure of prostate cancer but this must be balanced against the potential harms of overdiagnosis. Prostate-specific antigen (PSA) testing is commonly used but misses many aggressive prostate cancers, while also leading to overdiagnosis and overtreatment. A digital rectal examination (DRE) has also proven to be inaccurate for prostate cancer detection. [5]

“For men and physicians who proceed with screening, this next-generation approach [Stockholm3] is sensible, data-based, and more effective than traditional approaches”[6]

- Scott Eggener, MD, Professor, University of Chicago

Six reasons for Stockholm3

Stockholm3 can detect aggressive prostate cancer at an earlier stage - even in men with low PSA values (PSA values from 1.5 - 2.9 ng/ml). Early detected prostate cancer can almost always be effectively treated.

Stockholm3 can significantly reduce unnecessary biopsies and MRI examinations.

Stockholm3 has been proven to work equally well in various ethnicities, including Caucasians, African Americans, Hispanics, and Asian men.

Stockholm3 is based on clinical studies including over 90,000 European and North American men.

Stockholm3 is included in European (EAU) and American (AUA) guidelines for prostate cancer.

Stockholm3 saves significant healthcare resources and costs. [7]

The current situation and challenges

Until now, only prostate-specific antigen (PSA) testing has been available for the early detection of prostate cancer.

PSA levels are not elevated in 30-50% of all early-stage aggressive prostate cancers, which means they are not detected.

PSA also leads to overdiagnosis because it cannot differentiate between aggressive and benign tumors. The additional testing required is associated with side effects, including infections and blood in the urine and feces.

Prostate biopsies are invasive and carry a risk of infection, so they should be reserved for cases where they are truly necessary. [8]

Early identification of men with aggressive prostate cancer leads to a higher than 99% survival rate

Stockholm3 is a blood test that combines protein biomarkers, genetic biomarkers, and clinical information and combines them into an algorithm. This leads to a more accurate risk assessment than PSA. Stockholm3 detects 41-89% more men with aggressive prostate cancer and simultaneously reduces overdetection by 37-52% compared with PSA.

Stockholm3 ensures that men with a high risk of aggressive prostate cancer but low PSA are identified at an earlier stage. At the same time, Stockholm3 reduces the number of men with elevated PSA levels who are referred to MRI testing and/or prostate biopsy. [9]

Why is Stockholm3 better?

Stockholm3 can be used by all men aged 45-74 who have not previously been diagnosed with prostate cancer.

FAQs

  • Stockholm3 is a blood-based test, that runs a combination of protein biomarkers, genetic biomarkers and clinical information through an algorithm to find the probability of clinically significant cancer at biopsy.

    Stockholm3 has been evaluated in clinical studies including more than 90,000 men. It is extensively tested in large population-based screening trials, as well as in real world clinical utility studies in primary care, as a reflex test to PSA at values 1.5-20 ng/ml.  Benefits include the ability to reduce unnecessary MRIs, benign and Grade Group 1 prostate biopsies for men with elevated PSA, while simultaneously improving detection of clinically significant cancers in men with low or normal PSA values.  Using Stockholm3 leads to a more accurate risk assessment than the current PSA standard. Stockholm3 detects 41-89% more men with aggressive prostate cancer and, at the same time, reduces over-detection by 37-52% compared to PSA.

    Multiple Stockholm3 studies have been published in high-impact journals such as The Lancet Oncology, Journal of Clinical Oncology, and European Urology. The studies address both the specificity and sensitivity of Stockholm3 in multi-ethnic populations as well as health-economic benefits of implementing it in clinical care. [2, 3]

  • Stockholm3 was developed by researchers at the Karolinska Institute in Stockholm, Europe’s leading medical university. It has been evaluated in clinical studies with more than 90,000 men of different ethnicities, including studies in the United States, Canada, Germany, Sweden, Norway, and Switzerland.

  • Your test result will indicate whether you have a low, normal, or elevated risk of prostate cancer. If you have a normal or low risk, you will be recommended another prostate cancer test in two or six years, respectively. If you have an elevated risk, you will be recommended further examination with a magnetic camera and/or a biopsy in consultation with the attending physician.

  • Stockholm3 is currently available in the following European markets: Finland, Germany, Norway, Sweden, Switzerland, and the UK, as well as in the USA. For further details on how to order the test, please contact:

    Europe

    All other markets

  • 1. Grönberg et al. Prostate cancer screening in men aged 50–69 years (STHLM3): a prospective population-based diagnostic study. The Lancet Oncology. 2015

    Nordström et al. Prostate Cancer Screening Using a Combination of Risk-Prediction, MRI, and Targeted Prostate Biopsies. The Lancet Oncology. 2021

    Grönberg et al. Prostate Cancer Diagnostics Using a Combination of the Stockholm3 Blood Test and Multiparametric Magnetic Resonance Imaging. European Urology. 2018

    Viste et al. Effects of replacing PSA with Stockholm3 for diagnosis of clinically significant prostate cancer in a healthcare system - the Stavanger experience. SJPHC. 2020

    Palsdottir, T et. al. The Capio Prostate Cancer Center Model for Prostate Cancer Diagnostics – Real world evidence from 2018 to 2022. European Urology Opean Science. 2024 Jan 25

    Elyan et al. Prospective Multicenter Validation of the Stockholm3 Test in a Central European Cohort. Eur Urol Focus. 2023 Oct 7

    Fredsoe et al. Results from the PRIMA Trial: Comparison of the STHLM3 Test and Prostate-specific Antigen in General Practice for Detection of Prostate Cancer in a Biopsy-naïve Population. Eur Urol Oncol. 2023 Oct

    Vigneswaran et al. Stockholm3 in a Multiethnic Cohort for Prostate Cancer Detection (SEPTA): A Prospective Multicentered Trial. J Clin Oncol. 2024 Jul 22

    Tilki et al. External Validation of Stockholm3 in a Retrospective German Clinical Cohort. Eur Urol Focus. 2024 Aug 6

    2. Viste et al. Effects of replacing PSA with Stockholm3 for diagnosis of clinically significant prostate cancer in a healthcare system - the Stavanger experience. SJPHC. 2020

    Palsdottir, T et. al. The Capio Prostate Cancer Center Model for Prostate Cancer Diagnostics – Real world evidence from 2018 to 2022. European Urology Opean Science. 2024 Jan 25

    3. Grönberg et al. Prostate cancer screening in men aged 50–69 years (STHLM3): a prospective population-based diagnostic study. The Lancet Oncology. 2015

    Eklund et al. The Stockholm-3 (STHLM3) Model can Improve Prostate Cancer Diagnostics in Men Aged 50–69 yr Compared with Current Prostate Cancer Testing. European Urology Focus. 2016

    Grönberg et al. Prostate Cancer Diagnostics Using a Combination of the Stockholm3 Blood Test and Multiparametric Magnetic Resonance Imaging. European Urology. 2018

    Waldén M et al. A Head-to-head Comparison of Prostate Cancer Diagnostic Strategies Using the Stockholm3 Test, Magnetic Resonance Imaging, and Swedish National Guidelines: Results from a Prospective Population-based Screening Study. European Urology Open Science. 2022

    Vigneswaran et al. Stockholm3 validation in a multi-ethnic cohort for prostate cancer (SEPTA) detection: A multicentered, prospective trial. JCO supplements, ASCO-GU 2024 presentation, 2024, Jan 25. Vigneswaran et al. Stockholm3 in a Multiethnic Cohort for Prostate Cancer Detection (SEPTA): A Prospective Multicentered Trial. J Clin Oncol. 2024 Jul 22

    Tilki et al. External Validation of Stockholm3 in a Retrospective German Clinical Cohort. Eur Urol Focus. 2024 Aug 6

    4. Bergman et al. Structured care for men who want to get tested for prostate cancer – findings from Capio Prostate Cancer Center. Läkartidningen. 2018;115:FCDT

    Viste et al. Effects of replacing PSA with Stockholm3 for diagnosis of clinically significant prostate cancer in a healthcare system - the Stavanger experience. SJPHC. 2020, Söderbäck et al. Improved prostate cancer diagnostics with a structured pathway including Stockholm 3 test, MRI and targeted perineal biopsies. Läkartidningen. 2023

    Mcleod et al. Cost Effectiveness of Prostate Cancer Testing incorporating Stockholm3 and MRI versus standard of care. EAU 2024, April 7

    Hao S et al. Cost-effectiveness of Stockholm3 test and magnetic resonance imaging in prostate cancer screening: a microsimulation study. European Urology. 2022.

    5. Thompson et al. Prevalence of Prostate Cancer among Men with a Prostate-Specific Antigen Level ≤4.0 ng per Milliliter. NEJM 2004

    Naji et al. Digital Rectal Examination for Prostate Cancer Screening in Primary Care: A Systematic Review and Meta-Analysis. Ann Fam Med, 2018

    Krilaviciute et al. Digital Rectal Examination Is Not a Useful Screening Test for Prostate Cancer. European Urology Oncology, 2023

    6. Eggener S. Comment - Prostate cancer screening in men aged 50 to 69 years (STHLM3): A prospective population-based diagnostic study. Urol Oncol. 2017 Mar

    7. Grönberg et al. Prostate cancer screening in men aged 50–69 years (STHLM3): a prospective population-based diagnostic study. The Lancet Oncology. 2015

    Nordström et al. Prostate Cancer Screening Using a Combination of Risk-Prediction, MRI, and Targeted Prostate Biopsies. The Lancet Oncology. 2021

    Grönberg et al. Prostate Cancer Diagnostics Using a Combination of the Stockholm3 Blood Test and Multiparametric Magnetic Resonance Imaging. European Urology. 2018

    Viste et al. Effects of replacing PSA with Stockholm3 for diagnosis of clinically significant prostate cancer in a healthcare system - the Stavanger experience. SJPHC. 2020

    Palsdottir, T et. al. The Capio Prostate Cancer Center Model for Prostate Cancer Diagnostics – Real world evidence from 2018 to 2022. European Urology Opean Science. 2024 Jan 25

    Elyan et al. Prospective Multicenter Validation of the Stockholm3 Test in a Central European Cohort. Eur Urol Focus. 2023 Oct 7

    Fredsoe et al. Results from the PRIMA Trial: Comparison of the STHLM3 Test and Prostate-specific Antigen in General Practice for Detection of Prostate Cancer in a Biopsy-naïve Population. Eur Urol Oncol. 2023 Oct

    Vigneswaran et al. Stockholm3 in a Multiethnic Cohort for Prostate Cancer Detection (SEPTA): A Prospective Multicentered Trial. J Clin Oncol. 2024 Jul 22

    Tilki et al. External Validation of Stockholm3 in a Retrospective German Clinical Cohort. Eur Urol Focus. 2024 Aug 6

    Vigneswaran et al. Stockholm3 validation in a multi-ethnic cohort for prostate cancer (SEPTA) detection: A multicentered, prospective trial. JCO supplements, ASCO-GU 2024 presentation, 2024, Jan 25

    Waldén M et al. A Head-to-head Comparison of Prostate Cancer Diagnostic Strategies Using the Stockholm3 Test, Magnetic Resonance Imaging, and Swedish National Guidelines: Results from a Prospective Population-based Screening Study. European Urology Open Science. 2022

    Söderbäck et al. Improved prostate cancer diagnostics with a structured pathway including Stockholm 3 test, MRI and targeted perineal biopsies. Läkartidningen. 2023,

    Mcleod et al. Cost Effectiveness of Prostate Cancer Testing incorporating Stockholm3 and MRI versus standard of care. EAU 2024, April 7

    Hao S et al. Cost-effectiveness of Stockholm3 test and magnetic resonance imaging in prostate cancer screening: a microsimulation study. European Urology. 2022

    Mottet et al. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer-2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol. 2021

    Wei, J.T., et al., Early Detection of Prostate Cancer: AUA/SUO Guideline Part I: Prostate Cancer Screening. J Urol, 2023.

    8. Thompson et al. Prevalence of Prostate Cancer among Men with a Prostate-Specific Antigen Level ≤4.0 ng per Milliliter. NEJM 2004

    Hamdy et al. Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer. NEJM, 2023

    Loeb, et al. Systematic review of complications of prostate biopsy. Eur Urol. 2013

    9. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023 Jan;73(1):17-48. doi: 10.3322/caac.21763. PMID: 36633525, Cancer Facts and Figures, American Cancer Society, 2023

    10. Viste et al. Effects of replacing PSA with Stockholm3 for diagnosis of clinically significant prostate cancer in a healthcare system - the Stavanger experience. SJPHC. 2020

    Palsdottir, T et. al. The Capio Prostate Cancer Center Model for Prostate Cancer Diagnostics – Real world evidence from 2018 to 2022. European Urology Opean Science. 2024 Jan 25