TOPLINE:

A large screening trial showed that using prostate-specific antigen density (PSAD) before MRI prevented overdiagnosis and lowered resource use while preserving the detection of clinically significant prostate cancer (PCa). However, PSAD cutoffs > 0.075 ng/mL 2 lowered MRI use but risked missing significant cases of cancer.

METHODOLOGY:

This randomised, prospective screening trial for PCa (STHLM3MRI) included 12,750 participants aged 50-74 years residing in Stockholm, Sweden, between 2018 and 2020.

Participants were randomly assigned to receive either a systematic prostate biopsy (standard group; n = 5134) or a specific PCa screening procedure (experimental group; n = 7609).

In the experimental group, men with PSA levels ≥ 3 ng/mL underwent a biparametric MRI, followed b

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