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Warm welcome to the FICAN science webinar. This webinar is organized by FICAN MID (Sisä-Suomen syöpäkeskus). The webinar will be held online in Teams and is open to everyone interested in cancer research.

Speaker: Prof. Anssi Auvinen, Tampere University

Title: A randomised pragmatic population-based trial of prostate cancer screening (ProScreen)

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Abstract:

We have shown in the ERSPC trial that PSA-based screening can reduce prostate cancer mortality, but due to extensive overdiagnosis of low-risk cases, the balance of benefits and harms is questionable.

We have designed a screening protocol aimed at minimising overdiagnosis, but maintaining the mortality impact. The screening intervention consist of three tests, provided in a stepwise fashion: First PSA, for men with PSA3 ng/ml also a kallikrein panel (4Kscore) and if it exceeds 7.5%, a referral to MRI. Men with a suspicious MRI findings (PI-RADS score 3–5) are referred to targeted prostate biopsy.

We have randomised 113,357 men aged 50–63 from Helsinki and Tampere metropolitan areas, with a quarter allocated to screening and the rest to the control arm.
Results from the first screening round show that large majority (80%) of the screen-detected cases are high-grade cancers (ISUP grade group 2–5). Compared with the control arm, one additional high-grade cancer was detected per 200 men, while the excess of low-grade cases (grade group 1) was considerably smaller (one excess case per 800 men).

References

Auvinen A, Tammela T, Mirtti T, et al. Prostate cancer screening with PSA, kallikrein panel and MRI: The ProScreen randomized trial. JAMA 2024;331:1452-59

Rannikko A, Leht M, Mirtti T, ym. Population-based randomized trial of screening for clinically significant prostate cancer: A pilot study. BJU Int 2022;130:193-199

Bratt O, Auvinen A, Godtman AR, ym. Screening for prostate cancer. BMJ Oncol 2023;2:e000039