First prize at the EAU Congress for study on efficient prostate cancer testing
The study “Reducing MRI Use in Organised Prostate Cancer Testing Using Blood-Based Biomarkers - the OPT Stockholm3 Study” (Falagario et al.) from Karolinska Institutet and Region Stockholm has been awarded First Prize for Best Oncology Abstract at the 41st Annual Congress of the European Association of Urology (EAU) in London 2026.
The study was conducted within the organised prostate cancer testing (OPT) programme in Region Stockholm-Gotland and investigated how the blood-based Stockholm3 test can be used as a reflex test following PSA. Stockholm3 is a blood-based, multivariable risk test that combines protein biomarkers, genetic markers, and clinical variables to estimate the risk of clinically significant prostate cancer. The aim was to reduce the number of magnetic resonance imaging examinations and biopsies without compromising the detection of clinically significant prostate cancer.
50-year-old men in Region Stockholm-Gotland were tested
Researchers compared two different testing strategies in 50-year-old men in Region Stockholm-Gotland over two consecutive years:
- In the first year, men with PSA levels above 3 ng/mL were referred directly to magnetic resonance imaging.
- In the second year, men with elevated PSA first underwent the more advanced Stockholm3 blood test. Only those identified as having an increased risk of clinically significant cancer were referred to magnetic resonance imaging.
More than 13,000 men participated in the study. The results showed that when Stockholm3 was introduced as an additional step, magnetic resonance imaging examinations decreased by 64 percent and biopsies by 33 percent. At the same time, detection of more aggressive prostate cancer was similar between the groups, although the study was not designed to detect small differences in cancer detection rates.
The researchers also examined whether the PSA threshold for using the Stockholm3 test could be adjusted. Testing men with PSA levels above 2 ng/mL resulted in approximately 400 more Stockholm3 tests compared with testing only men with PSA above 3 ng/mL, without detecting any additional cancer cases in this age group. In this study, the lower threshold therefore did not appear to provide any added benefit.
“Our findings demonstrate that it is possible to integrate an advanced blood-based risk test into an organised prostate cancer testing programme while reducing the burden on healthcare resources. This is important both for patients and for the sustainability of healthcare systems,” says Anna Lantz, Associate Professor at the Department of Molecular Medicine and Surgery and consultant urologist at Karolinska University Hospital, who led the study.
“Longer follow-up will be required to evaluate how this strategy affects cancer detection and clinical outcomes over time,“ she continues.
The study was funded by the Swedish Prostate Cancer Federation and Region Stockholm (ALF).
Abstract
Stockholm3 test performance for reducing MRI in Organised Prostate Cancer Testing (OPT)
European Association of Urology, EAU
The EAU Congress is one of the largest and most influential meetings in urology worldwide, attracting more than 15,000 researchers and clinicians each year. The 41st Annual EAU Congress (EAU26) was held in London on March 13-16.