Comparing Biopsy Methods for Detecting Clinically Significant Prostate Cancer
Posted: Tuesday, August 31, 2021
According to a population-based noninferiority trial of prostate cancer screening in men between the ages of 50 and 74 published in The New England Journal of Medicine, MRI-targeted biopsies proved to be noninferior to standard biopsies—resulting in less detection of clinically insignificant tumors and showing equivalent or superior accuracy in detecting clinically significant tumors. Tobias Nordström MD, PhD, of Danderyd Hospital, Stockholm, and colleagues also presented these study findings at the European Association of Urology Congress.
“Our results from a large, randomized 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,” commented Dr. Nordström in an institutional press release.
In the 12,750-patient study from Stockholm County, men between 50 and 74 with prostate-specific antigen levels of 3 ng/mL and higher were selected to undergo biopsy. About 603 men underwent a standard biopsy, and 929 underwent the experimental biopsy. An intention-to-treat analysis discovered that clinically significant cancer was diagnosed in 21% of men in the experimental group (n = 192) and 18% of men in the standard group (n = 106). However, 4% of men in the experimental group were diagnosed with clinically insignificant disease as opposed to 12% of men in the standard group. In a second report soon to be presented by the study investigators, the role of a novel MRI adjunct blood test will be discussed.
“The markedly reduced incidences of unnecessary biopsy and diagnosis of clinically insignificant cancer address key barriers impeding implementation of population-based screening for prostate cancer,” the study investigators concluded.
Disclosure: For full disclosures of the study authors, visit nejm.org.