A new blood test could make it easier to detect the most dangerous form of prostate cancer early. According to a study by Karolinska Institutet, the Stockholm 3 blood test detected more clinically significant cancer cases than the PSA test, without subjecting more men to unnecessary testing. This research Annals of Internal Medicine.
In a large population-based study of 12,670 men aged 50 to 74, researchers at Karolinska Institutet in Sweden showed that the blood-based Stockholm 3 test was able to identify aggressive prostate cancers much better than the traditional PSA test. Stockholm 3 detected 90 percent of aggressive cancer cases, compared to 74 percent of PSA cases.
The need for a better way
Prostate cancer is one of the most common forms of cancer among men worldwide. Although the PSA test has long been used for early detection, it is controversial because it can miss more aggressive tumors or lead to unnecessary further tests or biopsies. The new results suggest that Stockholm3 may provide a more accurate alternative.
The main challenge in prostate cancer screening is not only to find more cancer cases, but also to identify the truly dangerous cancers. Our results show that Stockholm3 is able to identify much more aggressive cancer cases than PSA without increasing the number of unnecessary follow-ups. ”
Thorgerdur Palsdottir, Researcher, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet
This study is based on the population-based STHLM3-MRI study. All participants underwent both PSA and Stockholm 3 testing and were followed for 2 years through the National Cancer Registry. This also made it possible to identify cancer cases missed during initial screening.
Fewer critical cases are missed
During follow-up, 443 men were diagnosed with clinically significant, or aggressive, prostate cancer. Stockholm 3 missed significantly fewer serious cancer cases than PSA, although the proportion of men incorrectly classified as high risk was similar for both tests.
“These results indicate that the way prostate cancer screening is performed may change. More accurate blood tests could allow for early detection of malignant disease while reducing the number of unnecessary additional tests and procedures,” says Torgeldur Parsdóttir.
Researchers emphasize that long-term follow-up is needed to fully assess the impact on mortality and long-term outcomes.
The study was conducted in collaboration with researchers and clinicians in Sweden, Europe, and the United States. This study was funded by the Swedish Research Council, the Stockholm Region, the Swedish Prostate Cancer Federation, and the Swedish Cancer Society. The researchers say the funders had no role in the study design or interpretation of the results.
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Reference magazines:
Parsdottir, T. others. (2026) Stockholm 3 – Population-based prostate cancer screening study using magnetic resonance imaging: 2-year follow-up. Annual report of internal medicine. DOI: 10.7326/ANNALS-25-04753. https://www.acpjournals.org/doi/10.7326/ANNALS-25-04753
