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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.
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.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
17,980 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Detection of clinically insignificant prostate cancerprimary | MRI-targeted biopsy only | - | 0.6% | 0.46 | - | link |
| Systematic plus targeted biopsy | - | 1.2% |
Shares ERSPC (European Randomized Study of Screening for Prostate Cancer), Overdiagnosis, PSA (prostate-specific antigen), Prostate cancer.
Shares Prostate Cancer Screening with PSA and MRI Followed by Targeted Biopsy Only, PSA and MRI-first prostate cancer screening, Overdiagnosis, PSA (prostate-specific antigen).
Shares Prostate Cancer Screening with PSA and MRI Followed by Targeted Biopsy Only, PSA and MRI-first prostate cancer screening, Overdiagnosis, PSA (prostate-specific antigen).
Shares Multiparametric prostate MRI (PI-RADS), PSA and MRI-first prostate cancer screening, Prostate cancer.
Shares Multiparametric prostate MRI (PI-RADS), PSA (prostate-specific antigen), Prostate cancer.
Shares Prostate Cancer Screening with PSA and MRI Followed by Targeted Biopsy Only, PSA and MRI-first prostate cancer screening, Overdiagnosis, PSA (prostate-specific antigen).
Shares Prostate Cancer Screening with PSA and MRI Followed by Targeted Biopsy Only, PSA and MRI-first prostate cancer screening, Overdiagnosis, PSA (prostate-specific antigen).
Shares Prostate Cancer Screening with PSA and MRI Followed by Targeted Biopsy Only, PSA and MRI-first prostate cancer screening, PSA (prostate-specific antigen), Prostate cancer.