Stockholm3 test – advanced PSA test with risk assessment
Stockholm3 is a blood test that combines several biomarkers (total PSA, free PSA, hK2, MSMB, MIC1 and 101 genetic markers) with clinical information such as age, previous prostate biopsy and heredity for prostate cancer. The result is presented as a Stockholm3 Risk Score, which estimates the risk of prostate cancer requiring treatment and provides a recommendation for possible continued follow-up. Important information: The analysis is performed by Stockholm3 and sampling can only be carried out at Unilab clinics in Stockholm, Gothenburg and Malmö.
Why choose Stockholm3 over a regular PSA test?
Stockholm3 provides a more comprehensive risk assessment than a single PSA value by weighing together biomarkers, genetic markers and clinical information. The test is intended for men between 45 and 74 years of age who have not previously been diagnosed with prostate cancer and may be particularly relevant in cases such as hereditary factors or the need for a more detailed risk assessment.
A more comprehensive assessment than PSA alone
In clinical studies, Stockholm3 has shown a better ability to identify prostate cancer requiring treatment and at the same time reduce the number of unnecessary biopsies compared to assessment based on PSA alone. This may provide better conditions for a more targeted further investigation.
Recommendations based on individual risk
A PSA value can be difficult to interpret in isolation. Stockholm3 provides both a Risk Score and a Recommendation based on the individual risk level. For example, in the case of low risk, the recommendation may be to wait with a new test for a longer period, while a higher risk level may mean a recommendation for further investigation.
The difference between Stockholm3 and a traditional PSA test
An elevated PSA value does not necessarily mean prostate cancer and can also be due to other changes in the prostate. Stockholm3 supplements PSA with additional biomarkers, genetic markers and clinical data to provide an overall assessment of the risk of prostate cancer requiring treatment and clearer guidance on the next step.
Interpretation of your test results
The result from Stockholm3 consists of two parts: Stockholm3 Risk Score, which indicates the estimated risk in percent for prostate cancer requiring treatment (ISUP ≥ 2) at biopsy, and Stockholm3 Recommendation, which indicates recommended continued follow-up based on the risk level. Stockholm3 is a risk assessment and not a diagnosis. In case of increased risk, further investigation by a urologist may be recommended.
Mandatory questions when ordering a test
When ordering, you need to answer the following questions in the health declaration, which is activated in connection with the referral after the purchase has been made:
- Age at the time of sampling:
- What is the patient's age at the time of sampling?
- Family history of prostate cancer:
- Has your father or any of your brothers or sons been diagnosed with prostate cancer? [Yes/No/Don't Know]
- Medication:
- Have you taken any of the following medications now or in the past 3 months continuously: dutasteride (e.g. Avodart) or finasteride (e.g. Proscar, Finasteride, etc.)? [Yes/No/Don't Know]
- Previous prostate biopsy:
- Have you previously undergone a prostate biopsy? [Yes/No/Don't Know]
Before the test
No fasting is required. To reduce the risk of a temporary elevated PSA value, we recommend that you avoid ejaculation and prolonged cycling for 48 hours before the test. Also inform if you are using 5-alpha reductase inhibitors such as finasteride or dutasteride, or high doses of biotin, as this may affect the analysis.
The result from the Stockholm3 test consists of two parts:
- Stockholm3 Risk Score: A risk assessment that indicates the likelihood of prostate cancer requiring treatment (ISUP ≥ 2) at biopsy.
- Stockholm3 Recommendation: A recommendation for continued care and possible follow-up based on the risk assessment.
Response categories for Stockholm3 Recommendation
- Low risk: Stockholm3 Risk Score 0–3 %
- Normal risk: Stockholm3 Risk Score 4–10%
- Increased risk with volume cut-off: Stockholm3 Risk Score 11–29%
- Increased risk without volume cut-off: Stockholm3 Risk Score ≥ 30 %
Results provided based on risk level
- High risk (Stockholm3 Risk Score ≥ 11):
- Stockholm3 Risk Score
- Total PSA
- Stockholm3 Prostate Volume Cut-Off (if applicable)
- Normal risk (Stockholm3 Risk Score 4–10):
- Stockholm3 Risk Score
- Total PSA
- Low risk (Stockholm3 Risk Score < 4):
- Stockholm3 Risk Score
- Total PSA with the answer ≤ 1.5 ng/ml
Important about the PSA threshold of 1.5 ng/ml
According to the Stockholm3 method, the extended analysis with protein markers, genetic markers and algorithm is performed when the total PSA is ≥ 1.5 ng/ml. At PSA < 1.5 ng/ml, PSA is reported and the risk is assessed as low, which means that the entire Stockholm3 panel is not performed.
Delivery of test results
You will receive your doctor-commented test results via Min Journal with BankID. The usual response time is approximately 1–2 weeks.
Stockholm3 is not recommended after the age of 74
Stockholm3 is generally not recommended for men who have reached the age of 74. The reason is that the benefit of regular testing for early detection of prostate cancer decreases with increasing age, while the risk increases for detecting slow-growing prostate cancer that would never have time to cause symptoms or affect life expectancy.
For men over 74 years of age, the need for a PSA test, Stockholm3 or other investigation should therefore be assessed individually together with a doctor, for example in the event of symptoms, previously elevated PSA values or other suspicion of prostate cancer.
