ArticleScandinavian journal of primary health care2020
Effects of replacing PSA with Stockholm3 for diagnosis of clinically significant prostate cancer in a healthcare system - the Stavanger experience.
Article in Scandinavian journal of primary health care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 33 citations in OpenAlex.
- STHLM3 NorDCaP: prospective multicentre trial of Stockholm3 for active surveillance biopsy guidance.BJU international · 2026Trial
- Biomarker vs MRI-Enhanced Strategies for Prostate Cancer Screening: The STHLM3-MRI Randomized Clinical Trial.JAMA network open · 2024Trial
- Omitting biopsy in Prostate Imaging Reporting and Data System 3? The role of Stockholm3 and prostate-specific antigen density findings from a prospective Swiss non-referral cohort.Prostate international · 2026Article
- Integrative advances in biomarker-driven prostate cancer management from genomic discovery to precision oncology.Discover oncology · 2026Review
- Stockholm3 in a Multiethnic Cohort: Optimizing Prostate Cancer Screening to Reduce Harm and Improve Equity.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Article
- Cost Analysis of Prostate Cancer Care Using a Biomarker-enhanced Diagnostic Strategy with Stockholm3.European urology open science · 2024Article
- The Capio Prostate Cancer Center Model for Prostate Cancer Diagnostics-Real-world Evidence from 2018 to 2022.European urology open science · 2024Article
- Article
- A new approach to prostate cancer screening.Advances in laboratory medicine · 2023Article
- Cost-Effectiveness Analysis of Stockholm 3 Testing Compared to PSA as the Primary Blood Test in the Prostate Cancer Diagnostic Pathway: A Decision Tree Approach.Applied health economics and health policy · 2022Article
- Men's perception of information and psychological distress in the diagnostic phase of prostate cancer: a comparative mixed methods study.BMC nursing · 2022Article
- General practitioners' reflections on using PSA for diagnosis of prostate cancer. A qualitative study.Scandinavian journal of primary health care · 2022Article
- [Stockholm3 (STHLM3) MRI-on the pathway toward multimodal diagnostic approach for prostate cancer?]Der Urologe. Ausg. A · 2022Article
- Equitable access to cancer patient pathways in Norway - a national registry-based study.BMC health services research · 2021Article
- Alterations in protein expression and site-specific N-glycosylation of prostate cancer tissues.Scientific reports · 2021Article
- Tissue- and Liquid-Based Biomarkers in Prostate Cancer Precision Medicine.Journal of personalized medicine · 2021Review
- Prostate Cancer Liquid Biopsy Biomarkers' Clinical Utility in Diagnosis and Prognosis.Cancers · 2021Review
- The Genetic Complexity of Prostate Cancer.Genes · 2020Review
- A Nordic initiative for a more personal and accurate diagnostic pathway for prostate cancer.Scandinavian journal of primary health care · 2020Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe early experience of replacing PSA with Stockholm3 for detection of prostate cancer in primary care. DESIGN AND
methodsLongitudinal observations, comparing outcome measures before and after the implementation of Stockholm3.
settingStavanger region in Norway with about 370,000 inhabitants, 304 general practitioners (GPs) in 97 primary care clinics, and one hospital.
interventionGPs were instructed to use Stockholm3 instead of PSA as standard procedure for diagnosis of prostate cancer.
main outcome measuresProportion of GP clinics that had ordered a Stockholm3 test. Number of men referred to needle biopsy. Distribution of
resultsStockholm3 was rapidly implemented as 91% (88/97) of the clinics started to use the test within 14 weeks. After including 4784 tested men, the percentage who would have been referred for prostate needle biopsy was 29.0% (1387/4784) if based on PSA level ≥3ng/ml, and 20.8% (995/4784) if based on Stockholm3 Risk Score (
conclusionReplacing PSA with Stockholm3 for early detection of prostate cancer in primary care is feasible. Implementation of Stockholm3 resulted in reduced number of referrals for needle-biopsy and a higher proportion of clinically significant prostate cancer findings in performed biopsies. Direct healthcare costs decreased. KEY POINTS A change from PSA to Stockholm3 for the diagnosis of prostate cancer in primary care in the Stavanger region in Norway is described and assessed. •Implementation of a new blood-based test for prostate cancer detection in primary care was feasible. A majority of GP clinics started to use the test within three months. •Implementation of the Stockholm3 test was followed by: -a 28% reduction in number of men referred for urological prostate cancer work-up -an increase in the proportion of clinically significant cancer in performed prostate biopsies from 42 to 65% -an estimated reduction in direct health care costs between 23 and 28%.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.