Greater clinical net benefit for Stockholm3, driven by fewer false-negative results
THURSDAY, June 25, 2026 (HealthDay News) — Stockholm3, which combines prostate-specific antigen (PSA), plasma protein biomarkers, polygenic risk, and clinical factors offers greater clinical net benefit for detecting clinically significant prostate cancer (csPC) than PSA, according to a study published online June 23 in the Annals of Internal Medicine.
Thorgerdur Palsdottir, Ph.D., from Karolinska Institutet in Stockholm, and colleagues compared detection of csPC using PSA and Stockholm3 in a secondary analysis of the baseline round of the prospective Prostate Cancer Screening Using a Combination of Risk-Prediction, MRI (magnetic resonance imaging), and Targeted Prostate Biopsies randomized screening trial in men aged 50 to 74 years. Men with abnormal screening tests were randomly assigned to systematic biopsy or MRI with systematic and targeted biopsies for lesions with a Prostate Imaging Reporting and Data System score of 3 or greater in a 2:3 ratio.
The researchers found that 443 (3.5 percent) of the 12,670 men were diagnosed with csPC. Higher net benefit was seen for Stockholm3 versus PSA across a range of decision thresholds for biopsy in decision curve analysis, indicating fewer unnecessary biopsies and fewer missed cases of csPC. The false-negative rate was 10 percent and false-positive rate was 11 percent for Stockholm3 (≥11), while PSA (≥3 ng/mL) had a false-negative rate of 26 percent and false-positive rate of 10 percent. Sensitivity was 90 and 74 percent for Stockholm3 and PSA, respectively, with specificity of 89 and 90 percent, respectively.
“These findings support the use of Stockholm3 in the context of a risk-adapted screening approach, enabling more precise identification of men at higher risk for clinically significant disease while reducing unnecessary biopsies,” the authors write.
Several authors disclosed ties to the pharmaceutical and biomedical industries.
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