Koitsalu Marie, Eklund Martin, Adolfsson Jan, Sprangers Mirjam A G, Grönberg Henrik, Brandberg Yvonne
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Eur Urol Open Sci. 2021 Jan 7;24:43-51. doi: 10.1016/j.euros.2020.12.010. eCollection 2021 Feb.
The new STHLM3 test, combining protein markers, genetic markers, and clinical data to assess a man's prostate cancer (PCa) risk, has been investigated in Sweden within the frame of the STHLM3 trial.
To assess whether the STHLM3 test influences men's worry level, PCa knowledge, attitude, and health-related quality of life (HRQoL).
Invitations with login to the web survey were mailed to 10 000 men, 50-69 yr of age, who were eligible for the STHLM3 trial. The survey was sent 3 mo invitation to the STHLM3 trial (baseline) and 5 mo STHLM3 (follow-up). At baseline, the men were unaware of the upcoming invitation to STHLM3. The survey covered the following: PCa-specific worry and perceived vulnerability, knowledge about PCa, attitude toward PCa testing and health behavior, and HRQoL.
Survey scores were compared between baseline and follow-up by using the nonparametric Wilcoxon-signed rank tests for paired samples. Analysis of covariance was performed for PCa risk group comparisons.
A total of 994 men (10%) responded to our survey at baseline and follow-up, and were assessed as follows: low risk: 421 men; intermediate risk: 421 men; and high risk:152, of whom 59 were diagnosed with PCa after further investigation. In men assessed as having low and intermediate risk, level of worrying decreased at follow-up ( < 0.001), whereas no changes were observed in men at high risk. Moreover, no HRQoL changes were observed over time. The low response rate is the main limitation.
We found that the STHLM3 model, a risk-based PCa test, showed no negative impact on the well-being of men.
Since our results suggest that the risk-based screening as used in STHLM3 did not induce negative psychological effects on the participants, we can recommend this risk-based approach for population-based prostate cancer screening.
新型STHLM3检测结合蛋白质标志物、基因标志物和临床数据来评估男性患前列腺癌（PCa）的风险，该检测已在瑞典的STHLM3试验框架内进行了研究。
评估STHLM3检测是否会影响男性的担忧程度、对PCa的了解、态度以及与健康相关的生活质量（HRQoL）。
设计、设置和参与者：向10000名年龄在50 - 69岁且符合STHLM3试验条件的男性邮寄了带有网络调查登录信息的邀请函。该调查在STHLM3试验邀请前3个月（基线）和STHLM3试验邀请后5个月（随访）进行。在基线时，这些男性并不知道即将收到STHLM3试验的邀请。调查涵盖以下内容：PCa特异性担忧和感知到的易感性、对PCa的了解、对PCa检测和健康行为的态度以及HRQoL。
使用配对样本的非参数Wilcoxon符号秩检验比较基线和随访之间的调查得分。对PCa风险组进行协方差分析。
共有994名男性（10%）在基线和随访时回复了我们的调查，并进行了如下评估：低风险：421名男性；中风险：421名男性；高风险：152名男性，其中59名在进一步检查后被诊断为PCa。在被评估为低风险和中风险的男性中，随访时担忧程度降低（<0.001），而高风险男性未观察到变化。此外，未观察到HRQoL随时间的变化。主要局限性是低回复率。
我们发现基于风险的PCa检测STHLM3模型对男性的幸福感没有负面影响。
由于我们的结果表明STHLM3中使用的基于风险的筛查对参与者没有产生负面心理影响，我们可以推荐这种基于风险的方法用于基于人群的前列腺癌筛查。
