Evidence map›Paper›PMID 36477032›Full record

Trial reportThe New England journal of medicine2022

Prostate Cancer Screening with PSA and MRI Followed by Targeted Biopsy Only.

Jonas Hugosson, Marianne Månsson, Jonas Wallström, Ulrika Axcrona, Sigrid V Carlsson, Lars Egevad, Kjell Geterud, Ali Khatami, Kimia Kohestani, Carl-Gustaf Pihl and 5 more

4 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 180 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
180citing papers in PubMed, 7 pooled it
46.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

NCT05820113 nacompletednot on this map

Deep Learning Super Resolution Reconstruction for Fast and Motion Robust T2-weighted Prostate MRI

TypeinterventionalSponsorUniversity Hospital, BonnRan2022 to 2022Enrolled109ConditionsProstate Cancer, Multiparametric MRIArmsDeep learning based reconstruction of T2-TSE sequence
NCT06244680 completednot on this mapstarted 2023, after this paper: background citation

Super-fast 3T Prostate MRI Using High Gradient Strength and Deep Learning: Initial Experience

TypeobservationalSponsorUniversity Hospital, BonnRan2023 to 2023Enrolled77ConditionsProstate CancerArmsMRI of the prostate
NCT07398690 narecruitingnot on this mapstarted 2026, after this paper: background citation

Integrated Noninvasive Strategy Guided by Multiparametric MRI and the Prostate Health Index for Risk-Adapted Detection of Clinically Significant Prostate Cancer: A Multicenter Randomized Controlled Trial (INSIGHT-PCa Study)

TypeinterventionalSponsorIn Gab Jeong, MDRan2026 to 2029Enrolled1,432ConditionsProstate Cancer (Diagnosis), Prostate CancerArmsDiagnostic Procedure
NCT07682415 phase2not yet recruitingnot on this mapstarted 2026, after this paper: background citation

A Single-arm, Multicenter, Prospective Phase II Clinical Trial of Delayed Fixed-duration Combination With Sotoraclax Following Zanubrutinib Induction in Patients With CLL/SLL: Stop Trial 2.0

TypeinterventionalSponsorYi ShuhuaRan2026 to 2034Enrolled60ConditionsCLL / SLLArms12 cycles of zanubrutinib followed by 12 cycles of zanubrutinib in combination with sonrotoclax, zanubrutinib maintenance until disease progression
3 · Its place in the literature

Who cites it

180 citing papers in PubMed, 7 syntheses or guidelines pooled it, 331 citations in OpenAlex.

  1. Pooled it
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  7. Guideline
  8. Trial
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  10. Transrectal Ultrasound-Guided Prostate Biopsy with and without PSMA-PET-Targeted Prostate Biopsy for Prostate Cancer Diagnosis.Clinical cancer research : an official journal of the American Association for Cancer Research · 2025
    Trial
  11. Trial
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  16. Observational
  17. Review
  18. Successes and challenges in developing a magnetic resonance imaging-transrectal ultrasound machine fusion prostate biopsy service.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2026
    Review
  19. Article
  20. Article

120 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 5 institutions in 3 countries.

Jonas HugossonFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
Marianne MånssonFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
Jonas WallströmFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
Ulrika AxcronaFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
Sigrid V CarlssonFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
Lars EgevadFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
Kjell GeterudFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
Ali KhatamiFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
Kimia KohestaniFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
Carl-Gustaf PihlFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
Andreas SocratousFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
Johan StranneFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
Rebecka Arnsrud GodtmanFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
Mikael HellströmFrom the Departments of Urology (J.H., A.K., K.K., J.S., R.A.G.), Radiology (J.W., K.G., A.S., M.H.), and Pathology (C.-G.P.), Sahlgrenska University Hospital-Sahlgrenska Academy at Gothenburg University, and the Department of Urology, Sahlgrenska Academy at Gothenburg University (J.H., M.M., S.V.C.), Gothenburg, and the Department of Oncology-Pathology, Karolinska Institute, Stockholm (L.E.) - all in Sweden; the Departments of Pathology and Molecular Oncology, Oslo University Hospital-Radiumhospitalet, Oslo (U.A.); and the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York (S.V.C.).
GÖTEBORG-2 Trial Investigators
Sahlgrenska University Hospital · SEUniversity of Gothenburg · SEKarolinska Institutet · SEMemorial Sloan Kettering Cancer Center · USMolecular Oncology (United States) · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
Improving shared decision making in cancer screeningK22CA234400 · NCI · SLOAN-KETTERING INST CAN RESEARCH · PI CARLSSON, SIGRID · 2019 to 2021
$621k
NCI NIH HHS K22 CA234400NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundScreening for prostate cancer is burdened by a high rate of overdiagnosis. The most appropriate algorithm for population-based screening is unknown.

methodsWe invited 37,887 men who were 50 to 60 years of age to undergo regular prostate-specific antigen (PSA) screening. Participants with a PSA level of 3 ng per milliliter or higher underwent magnetic resonance imaging (MRI) of the prostate; one third of the participants were randomly assigned to a reference group that underwent systematic biopsy as well as targeted biopsy of suspicious lesions shown on MRI. The remaining participants were assigned to the experimental group and underwent MRI-targeted biopsy only. The primary outcome was clinically insignificant prostate cancer, defined as a Gleason score of 3+3. The secondary outcome was clinically significant prostate cancer, defined as a Gleason score of at least 3+4. Safety was also assessed.

resultsOf the men who were invited to undergo screening, 17,980 (47%) participated in the trial. A total of 66 of the 11,986 participants in the experimental group (0.6%) received a diagnosis of clinically insignificant prostate cancer, as compared with 72 of 5994 participants (1.2%) in the reference group, a difference of -0.7 percentage points (95% confidence interval [CI], -1.0 to -0.4; relative risk, 0.46; 95% CI, 0.33 to 0.64; P<0.001). The relative risk of clinically significant prostate cancer in the experimental group as compared with the reference group was 0.81 (95% CI, 0.60 to 1.1). Clinically significant cancer that was detected only by systematic biopsy was diagnosed in 10 participants in the reference group; all cases were of intermediate risk and involved mainly low-volume disease that was managed with active surveillance. Serious adverse events were rare (<0.1%) in the two groups.

conclusionsThe avoidance of systematic biopsy in favor of MRI-directed targeted biopsy for screening and early detection in persons with elevated PSA levels reduced the risk of overdiagnosis by half at the cost of delaying detection of intermediate-risk tumors in a small proportion of patients. (Funded by Karin and Christer Johansson's Foundation and others; GÖTEBORG-2 ISRCTN Registry number, ISRCTN94604465.).

Indexed as

Prostate-Specific AntigenProstatic NeoplasmsEarly Detection of CancerHumansMagnetic Resonance ImagingMaleProstate-Specific Antigen

Identifiers

PMID36477032
PMCPMC9870590
OpenAlexW4311843617

What OpenQuestion holds

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Read underepoch 390

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.