Evidence map›Paper›PMID 41882382›Full record

ArticleWorld journal of urology2026

Validation of Stockholm3 for prostate cancer detection in a swiss non-referral cohort: balancing biopsy reduction and diagnostic performance.

Jonas Mudlagk, Odile Minder, Ashkan Mortezavi, Benjamin Bulling, Julian Cornelius, Nicolas Arnold, Beat Roth, Livio Mordasini, Nicola Giudici

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jonas MudlagkDepartment of Urology, University Hospital Bern, Freiburgstrasse 37, Bern, 3010, Switzerland.
Odile MinderUroviva AG, Urologie-Praxis Sursee, Christoph-Schnyder-Strasse 2b, Sursee, 6210, Switzerland.
Ashkan MortezaviUniversity Hospital Zürich, Rämistrasse 100, Zürich, 8091, Switzerland.
Benjamin BullingDepartment of Urology, University Hospital Bern, Freiburgstrasse 37, Bern, 3010, Switzerland.
Julian CorneliusUroviva AG, Urologie-Praxis Sursee, Christoph-Schnyder-Strasse 2b, Sursee, 6210, Switzerland.
Nicolas ArnoldDepartment of Urology, University Hospital Bern, Freiburgstrasse 37, Bern, 3010, Switzerland.
Beat RothDepartment of Urology, University Hospital Bern, Freiburgstrasse 37, Bern, 3010, Switzerland.
Livio MordasiniUroviva AG, Urologie-Praxis Sursee, Christoph-Schnyder-Strasse 2b, Sursee, 6210, Switzerland.
Nicola GiudiciDepartment of Urology, University Hospital Bern, Freiburgstrasse 37, Bern, 3010, Switzerland. nicolagiudici@gmail.com.ORCID https://orcid.org/0009-0005-9844-1799

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeProstate cancer (PCa) diagnosis relies on PSA testing, but its low specificity leads to overdiagnosis. Stockholm3 may improve diagnostic accuracy. This study evaluated the performance of Stockholm3 for detecting clinically significant PCa (csPCa), defined as ISUP grade ≥ 2 on biopsy, in a real-world, non-referral Swiss cohort.

methodsRetrospective analysis of a prospective registry (2023-2025) at a non-referral urology practice in Switzerland. Initial screening was performed in men with PSA > 1.5 ng/mL or a suspicious digital rectal examination. Patients who underwent Stockholm3 and biopsy were included. We compared Stockholm3 with PSA, PSA density, and the SWOP risk calculator for the detection of csPCa in a pre-MRI diagnostic setting.

resultsWe included 178 men (median age 65 years, IQR: 60.0-70.0). Among them, 60/178 (33.7%) had csPCa. Stockholm3 ≥ 15 showed sensitivity 0.78 (95% CI 0.67-0.88), specificity 0.44 (95% CI 0.35-0.54), and AUC 0.68 (95% CI 0.60-0.77). SWOP score > 4% showed sensitivity 0.42 (95% CI 0.30-0.55), specificity 0.78 (95% CI 0.70-0.85), and AUC 0.68 (95% CI 0.59-0.76). Both tests outperformed PSA > 3 ng/mL and PSA density > 0.15 ng/mL², with AUCs of 0.52 (95% CI 0.48-0.56) and 0.57 (95% CI 0.50-0.64), respectively. Decision curve analysis and calibration curves favored Stockholm3 over SWOP.

conclusionsIn a non-referral setting, Stockholm3 confirmed good diagnostic performance for csPCa. These findings support its use as part of the primary diagnostic work-up in similar clinical settings.

Indexed as

Prostatic NeoplasmsAgedBiopsyClinical RelevanceHumansMaleMiddle AgedProstate-Specific AntigenRetrospective StudiesSwitzerlandProstate-Specific AntigenProstate cancerPSAPSA densityRisk stratificationStockholm3 testSWOP score

Identifiers

PMID41882382
PMCPMC13687149

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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.