Martin Eklund

This is the paper Europe PMC returns for registry id NCT02647099 with the most citations, so it is the natural first reading for anyone following the ALASCCA trial. Read the abstract above alongside the trial page and the registry entry; the record was linked automatically and its figures have not been checked by hand.

Screening programmes short of radiologists can read this as prospective evidence that a well-validated AI reader can take the second reader's seat without lowering cancer detection. It is a paired-reader study in one hospital, not a randomised trial, so MASAI and real-world follow-up carry the argument further.

Overdiagnosis, finding cancers that would never have caused harm, is the main reason Sweden's health authority advises against PSA screening. This trial showed that putting an MRI before the biopsy keeps the detection of cancers that matter while cutting the harmless ones by about two thirds. Sweden's regions have since begun organised prostate cancer testing, which the regional cancer centres describe as making PSA testing more equal and structured and helping to evaluate complementary tests; Socialstyrelsen still distinguishes it from screening.

It showed in a general population, not a referred clinic population, that a multi-marker risk score could spare many men a biopsy without missing more of the cancers that matter. The same group then tested the score inside the STHLM3-MRI screening trial.