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dc.contributor.authorViste, Eirik
dc.contributor.authorVinje, Cathrine Alvær
dc.contributor.authorLid, Torgeir Gilje
dc.contributor.authorSkeie, Svein
dc.contributor.authorEvjen-Olsen, Øystein
dc.contributor.authorNordström, Tobias
dc.contributor.authorThorsen, Olav
dc.contributor.authorGilje, Bjørnar
dc.contributor.authorJanssen, Emiel
dc.contributor.authorKjosavik, Svein Reidar
dc.description.abstractObjective To describe early experience of replacing PSA with Stockholm3 for detection of prostate cancer in primary care. Design and methods Longitudinal observations, comparing outcome measures before and after the implementation of Stockholm3. Setting Stavanger region in Norway with about 370,000 inhabitants, 304 general practitioners (GPs) in 97 primary care clinics, and one hospital. Intervention GPs were instructed to use Stockholm3 instead of PSA as standard procedure for diagnosis of prostate cancer. Main outcome measures Proportion of GP clinics that had ordered a Stockholm3 test. Number of men referred to needle biopsy. Distribution of clinically significant prostate cancer (csPC) (Gleason Score ≥7) and clinically non-significant prostate cancer (cnsPC) (Gleason Score 6), in needle biopsies. Estimation of direct healthcare costs. Results Stockholm3 was rapidly implemented as 91% (88/97) of the clinics started to use the test within 14 weeks. After including 4784 tested men, the percentage who would have been referred for prostate needle biopsy was 29.0% (1387/4784) if based on PSA level ≥3ng/ml, and 20.8% (995/4784) if based on Stockholm3 Risk Score (p < 0.000001). The proportion of positive biopsies with csPC increased from 42% (98/233) before to 65% (185/285) after the implementation. Correspondingly, the proportion of cnsPC decreased from 58% (135/233) before to 35% (100/285) after the implementation (p < 0.0017). Direct healthcare costs were estimated to be reduced by 23–28% per tested man. Conclusion Replacing PSA with Stockholm3 for early detection of prostate cancer in primary care is feasible. Implementation of Stockholm3 resulted in reduced number of referrals for needle-biopsy and a higher proportion of clinically significant prostate cancer findings in performed biopsies. Direct healthcare costs decreased.en_US
dc.publisherTaylor and Francisen_US
dc.rightsNavngivelse 4.0 Internasjonal*
dc.titleEffects of replacing PSA with Stockholm3 for diagnosis of clinically significant prostate cancer in a healthcare system – the Stavanger experienceen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.rights.holderCopyright 2020 The Author(s)en_US
dc.source.journalScandinavian Journal of Primary Health Careen_US
dc.identifier.citationScandinavian Journal of Primary Health Care. 2020, 38 (3), 315-322.en_US

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Navngivelse 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Navngivelse 4.0 Internasjonal