(Press-News.org) Most countries have not introduced nationwide prostate-cancer screening, as current methods result in overdiagnoses and excessive and unnecessary biopsies. A new study by researchers at Karolinska Institutet in Sweden, which is published in The New England Journal of Medicine, indicates that screening by magnetic resonance imaging (MRI) and targeted biopsies could potentially cut overdiagnoses by half. The results are presented today at the European Association of Urology Congress.
"Our results from a large, randomised study show that modern methods for prostate cancer screening maintain the benefits of screening, while decreasing the harms substantially. This addresses the greatest barrier to the introduction of nationwide screening," explains Tobias Nordström, associate professor of Urology at the Department of Clinical Sciences, Danderyd Hospital at Karolinska Institutet, who is in charge of the STHLM3MRI study.
Yearly, approximately 1,4 million men get a prostate cancer diagnosis and 375,000 men die from the disease. Previous studies have shown that organised screening can result in earlier detection and thereby reduce the risk of prostate-cancer deaths.
Current screening methods - PSA (prostate-specific antigen) tests combined with traditional biopsies - result in unnecessary biopsies, and the detection of numerous minor low-risk tumours. Consequently, no country except Lithuania has chosen to introduce a nationwide prostate-cancer screening programme, as the benefits do not exceed the disadvantages.
"Refined screening methods are required to reduce overdiagnosis and overtreatment of low-risk tumours, and prevent unnecessary biopsies and biopsy-related side-effects," explains Martin Eklund, associate professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, with joint responsibility for the STHLM3MRI study.
The results of the STHLM3MRI study indicate that overdiagnoses can be halved by substituting traditional prostate biopsies with magnetic resonance imaging (MRI) and targeted biopsies. The number of unnecessary biopsies and the identification of minor low-risk tumours is reduced, while the new method can detect just as many clinically significant tumours.
STHLM3MRI is a randomised study conducted between 2018 and 2021 with participants from Stockholm County, which included 12,750 men. The participants first provided a blood sample for PSA analysis, as well as analysis by the new Stockholm3 test, developed by researchers at Karolinska Institutet. Men whose tests showed elevated levels were then randomly selected for traditional biopsies or MRI. In the MRI group, biopsies were conducted strictly on suspected tumours identified by MRI.
The study proceeded thereafter by investigating how the Stockholm3 test could be combined with MRI to further improve the method for prostate-cancer screening.
"We will soon present the second of the two main reports from the STHLM3MRI trial where we assess the role of a novel blood test as adjunct to MRI in prostate cancer screening. The future of prostate cancer diagnostics probably includes both improved blood tests and MRI. Nationwide screening for breast and cervical cancer among women has been available in the Western world for some time. We are finally able to show that men can also reduce their risk of malignant cancer through nationwide prostate-cancer screening that utilises modern methods," Tobias Nordström concludes.
Professor Hendrik Van Poppel, Adjunct Secretary General of the European Association of Urology (EAU) said: "It is exciting to see breakthroughs such as this in the field of early detection of prostate cancer. An innovation such as STHLM3MRI makes an even more compelling case for the European Commission to ensure a risk stratified approach to early detection of prostate cancer is adopted across the whole of Europe. The EAU is working hard to ensure that early detection of prostate cancer is addressed in the implementation of Europe's Beating Cancer Plan in order to reduce mortality of Europe's most common male cancer while also dealing with the challenges of overdiagnosis and overtreatment. We are really looking forward to seeing how STHLM3MRI can continue to contribute to this aim".
INFORMATION:
The research was financed by the Swedish Cancer Society, the Swedish Research Council, the Swedish Research Council for Health, Working Life and Welfare, Karolinska Institutet, Hagstrandska Minnesfonden, Region Stockholm, the Swedish Order of Druids, the Åke Wiberg Foundation, the Swedish e-Science Research Center (SeRC) and Prostatacancerförbundet (the Prostate Cancer Association). Henrik Grönberg, Martin Eklund and Tobias Nordström are partners of the company A3P Biomedical AB, which holds the development rights of the Stockholm3 test.
Publication: "MRI-targeted or standard biopsy in prostate cancer screening", M. Eklund, F. Jäderling, A. Discacciati, M. Bergman, M. Annerstedt, M. Aly, A. Glaessgen, S. Carlsson, H. Grönberg, T. Nordström, for the STHLM3 consortium. The New England Journal of Medicine (NEJM), online 9 July 2021, doi: 10.1056/NEJMoa2100852.
Karolinska Institutet is one of the world's leading medical universities. Our vision is to advance knowledge about life and strive towards better health for all. Karolinska Institutet accounts for the single largest share of all academic medical research conducted in Sweden and offers the country's broadest range of education in medicine and health sciences. The Nobel Assembly at Karolinska Institutet selects the Nobel laureates in Physiology or Medicine.
About EAU21:
Europe's biggest urology congress will take place from 8th-12th July 2021 in a virtual setting. With over 1,500 abstracts presented and moderated live, the Annual Congress of the European Association of Urology (EAU21) will be amongst Europe's biggest medical congresses in 2021.
Clinicians, scientists, and patients will meet to discuss topics such as:
Prostate cancer: new developments to improve treatments of the most common male cancer
Urinary incontinence: a growing concern for the elderly population
Practice changing treatments for both bladder and kidney cancer
Prevention and treatment of urinary stones; 1 in 10 people (55 million adults in Europe) will form a stone at some point
Special track for representatives of patient advocacy group on Friday 9 July
...and many other conditions related to the male and female urinary tract system and male reproductive organs. Review the full scientific programme on https://eaucongress.uroweb.org/
Players of the popular game Red Dead Redemption 2 learn how to identify real American wildlife, new research shows.
The game, set in the American West in 1899, features simulations of about 200 real species of animals.
The new study, by the University of Exeter and Truro and Penwith College, challenged gamers to identify photographs of real animals.
On average, RDR2 players were able to identify 10 of 15 American animals in a multiple-choice quiz - three more than people who had not played the game.
The best performers were players who had completed the game's main storyline (meaning they had played for at least 40-50 hours) ...
Oncotarget published "Transcriptome analyses of urine RNA reveal tumor markers for human bladder cancer: validated amplicons for RT-qPCR-based detection" which reported that in case of bladder cancer, urine RNA represents an early potentially useful diagnostic marker.
Here the authors describe a systematic deep transcriptome analysis of representative pools of urine RNA collected from healthy donors versus bladder cancer patients according to established SOPs.
This analysis revealed RNA marker candidates reflecting coding sequences, non-coding sequences, and circular RNAs.
Next, they designed and validated PCR amplicons for a set of novel marker candidates and tested them in human bladder cancer cell lines.
This ...
INDIANAPOLIS - A new study from U.S. Department of Veterans Affairs, Regenstrief Institute, IUPUI and Icahn School of Medicine at Mount Sinai researchers reports that primary care physicians recognize the need for better coordination and welcome health information exchange (HIE) event notifications as a means of improving the flow of information to enable provision of better patient care.
Individuals often receive medical care from more than one healthcare system. Care coordination among providers, for example after discharge from an emergency department or hospital in one system, with the patient's primary care physician in another, is ...
Should we delay covid-19 vaccination in children?
The net benefit of vaccinating children is unclear, and vulnerable people worldwide should be prioritised instead, say experts in The BMJ today.
But others argue that covid-19 vaccines have been approved for some children and that children should not be disadvantaged because of policy choices that impede global vaccination.
Dominic Wilkinson, Ilora Finlay, and Andrew Pollard say for a health system to offer any vaccine to a child, two key ethical questions must be asked. First, do the benefits outweigh the risks? Second, if the vaccine is in short supply, does someone else need it more?
"Careful attention ...
*Note: this paper is being presented at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) and is being published in The Lancet Rheumatology. Please credit both the congress and the journal in your stories*
A new study presented at this year's European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) and published in The Lancet Rheumatology, shows that the antibody - but not the T-cell - response to the first dose of the Pfizer COVID-19 vaccine is weakened in patients taking the immunosuppressant methotrexate. In contrast, antibody and T cell responses are preserved in patients taking biological drugs such as tumour necrosis factor (TNF) inhibitors.
Around 3% to 7% of people in Europe and North America have ...
*Note: this paper is being presented at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) and is being published in The Lancet Microbe. Please credit both the congress and the journal in your stories*
A new study presented at this year's European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) and published in The Lancet Microbe, shows that antibodies generated by CoronaVac, an inactivated COVID-19 vaccine, work less well against the P.1 Brazil (Gamma) variant.
It also suggests that the P.1 variant may be able to reinfect individuals who previously had COVID-19. ...
Interim data from a phase 3 trial of a COVID-19 vaccine developed in China (CoronaVac) suggests that two doses offer 83.5% protection against symptomatic COVID-19.
The preliminary findings, published in The Lancet and presented at this year's European Congress of Clinical Microbiology & Infectious Diseases (ECCMID), indicate that CoronaVac induces a robust antibody response. No severe adverse events or deaths were reported among the more than 10,000 trial participants in Turkey, with most adverse events mild and occurring within 7 days of an injection. However, more research is needed to confirm vaccine efficacy in the long term, in a more diverse group of participants, and against emerging variants of concern.
CoronaVac uses an inactivated whole virus. When people receive the vaccine, ...
Led by the London School of Hygiene & Tropical Medicine (LSHTM), in partnership with the World Health Organization (WHO) and Avenir Health, the research team carried out a systematic review and meta-analysis of syphilis prevalence among MSM between 2000 to 2020, drawing on data from 275 studies involving more than 600,000 study participants across 77 countries.
The worldwide prevalence of syphilis among MSM was 15x higher than most recent estimates for men in the general population (7.5% versus 0.5%). Researchers further estimated the prevalence across eight regions of the Sustainable Development Goals (SDG) and six regions of the WHO. Latin America and the Caribbean region had the highest prevalence of syphilis (10.6%), whereas Australia and New Zealand had the lowest (1.9%). ...
A new paper in Nature lays out the way natural ecosystems parallel U.S. supply chains and how American cities can use these tools to strengthen their supply chains.
The paper, "Supply chain diversity buffers cities against food shocks," is co-authored by Benjamin Ruddell, director of the FEWSION Project and the School of Informatics, Computing, and Cyber Systems at Northern Arizona University, and Richard Rushforth, an assistant research professor in SICCS, in collaboration with FEWSION project researchers at Penn State. FEWSION is an NSF-funded collaboration that uses comprehensive data mapping to monitor domestic supply chains for food, water and energy down to the county level.
This research looks at the importance of diversity within the ...
Remember Napster? The peer-to-peer file sharing company, popular in the late 1990s and early 2000s, depended on users sharing their music files. To promote cooperation, such software "could mislead its users," says Bryce Morsky, a postdoc in Penn's School of Arts & Sciences.
Some file-sharing companies falsely asserted that all of their users were sharing. Or, they displayed the mean number of files shared per user, hiding the fact that some users were sharing a great deal and many others were not. Related online forums promoted the idea that sharing was both ethical and the norm. ...
