“…[65] The model
comprised protein biomarkers including PSA isoforms including some of those
in the PHI[66] and the 4Kscore[67, 68], as well as MSMB, MIC1, 232 SNPs and clinical variables
(age, family history, DRE, previous biopsy). Similar to the ERSPC and PCPT
risk calculators[61], the PHI[66] and 4Kscore[68] as well as PSA followed by MRI in the
Göteborg trial[16], the
STHLM3 test improved the specificity, increased the predictive accuracy of
finding GS 7 or higher (AUC 0.56, 95% CI 0.55–0.60 for PSA
vs. 0.74, 95% CI 0.55–0.60 for the STHLM3 test) and reduced
the number of unnecessary biopsies (by 32%, 95% CI
23–39). [65] While the
authors are to be congratulated for carrying out a major screening study,
which is certainly a step in the right direction, it is currently unknown
whether the STHLM3 test really provides the so-needed major change in the
balance of harms and benefit of PC screening.…”