{"entity":{"id":"goteborg-2","kind":"trial","name":"GÖTEBORG-2 (MRI-based prostate cancer screening)","aka":[],"tldr":"In GÖTEBORG-2, 17,980 men were screened with PSA, then MRI; biopsying only what the MRI showed halved the detection of harmless prostate cancers (0.6% versus 1.2% of men) while the detection of dangerous cancers barely changed (0.9% versus 1.1%). It is the strongest evidence that MRI-first screening cuts overdiagnosis.","summary":"17,980 men were invited; those with PSA of 3 ng/mL or more had MRI. In the experimental group (targeted biopsy of MRI-visible lesions only) clinically insignificant cancer was detected in 0.6% of men versus 1.2% in the reference group (systematic plus targeted biopsy), a relative risk of 0.46, while clinically significant cancer was found in 0.9% versus 1.1% (NEJM 2022). Follow-up rounds have shown that the deferred diagnoses rarely progress to advanced disease. The trial is the strongest evidence that MRI-first screening can retain the mortality benefit of PSA while cutting overdiagnosis.","status":"positive","asOf":"2026-09-10","links":[{"label":"GÖTEBORG-2 (NEJM 2022)","url":"https://doi.org/10.1056/NEJMoa2209454"}],"tags":[],"related":[],"cancers":["prostate"],"sections":[],"technologies":["prostate-screening-psa-mri","mp-mri"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["psa","overdiagnosis"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-goteborg-2-n-engl-j-med-2022"],"journals":[],"dependsOn":[],"notes":[],"nct":"ISRCTN94604465","phase":"3","setting":"Population-based screening of men aged 50 to 60 in Gothenburg: PSA then MRI, with MRI-targeted biopsy only versus systematic plus targeted biopsy","sponsor":"University of Gothenburg","result":"Clinically insignificant cancer 0.6% vs 1.2% (RR 0.46); clinically significant cancer 0.9% vs 1.1%.","yearReported":2022,"enrolled":17980,"enrolledBasis":"registry","outcomes":[{"endpoint":"Detection of clinically insignificant prostate cancer","primary":true,"unit":"%","arms":[{"name":"MRI-targeted biopsy only","value":0.6},{"name":"Systematic plus targeted biopsy","value":1.2}],"hr":0.46,"source":"https://doi.org/10.1056/NEJMoa2209454"}]},"route":"/trials/goteborg-2/","neighbours":{"cancer":[{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"technology":[{"id":"mp-mri","kind":"technology","name":"Multiparametric prostate MRI (PI-RADS)","route":"/technologies/mp-mri/"},{"id":"prostate-screening-psa-mri","kind":"technology","name":"PSA and MRI-first prostate cancer screening","route":"/technologies/prostate-screening-psa-mri/"}],"term":[{"id":"overdiagnosis","kind":"term","name":"Overdiagnosis","route":"/terms/overdiagnosis/"},{"id":"psa","kind":"term","name":"PSA (prostate-specific antigen)","route":"/terms/psa/"}],"paper":[{"id":"paper-goteborg-2-n-engl-j-med-2022","kind":"paper","name":"Prostate Cancer Screening with PSA and MRI Followed by Targeted Biopsy Only","route":"/key-papers/paper-goteborg-2-n-engl-j-med-2022/"}],"trial":[{"id":"erspc","kind":"trial","name":"ERSPC (European Randomized Study of Screening for Prostate Cancer)","route":"/trials/erspc/"}]}}