What is the Stockholm3 prostate cancer test?

Stockholm3 (SK3) is a sophisticated blood test that will accurately assess your percentage risk of developing an aggressive form of prostate cancer by measuring protein markers, 101 genetic markers and total and free PSA…all from one simple blood test.

Why not just do a PSA (prostate specific antigen)?

The NHS website (https://www.nhs.uk/conditions/prostate-cancer/psa-testing/) explains this very clearly.

“PSA tests are unreliable and can suggest prostate cancer when no cancer exists (a false-positive result). Most men are now offered an MRI scan before a biopsy to help avoid unnecessary tests, but some men may have invasive, and sometimes painful, biopsies for no reason.

Furthermore, around 1 in 7 of those with normal PSA levels may have prostate cancer (a false-negative result), so many cases may be missed. The PSA test can find aggressive prostate cancer that needs treatment, but it can also find slow-growing cancer that may never cause symptoms or shorten life. Some men may face difficult decisions about treatment, although this is less likely now that most men are offered an MRI scan before further tests and treatment.”

In summary, low levels on a PSA test alone do not always mean no aggressive cancer or risk. In the UK, acceptable levels of PSA vary by age and for men under 50 that level is a 2.5ngml. The SK3 detects men with aggressive tumours at levels starting at 1.5ngml, a whole point below. This means that some men are not getting vital early treatment for treatable cancers. And, some men will be diagnosed too late because the national guidelines on their previous PSA showed a ‘low’ result which didn’t require them to have an MRI. Conversely, a ‘high’ PSA could result in you being referred for an MRI. And while an MRI is great for locating areas of suspicion it is hard to distinguish between the tumours that will spread (aggressive) and prostate lesions that won’t. So aggressive tumour or not, you may then be sent for a biopsy which can be unpleasant and carry an infection risk. The SK3 can accurately predict your personalised risk of developing an aggressive prostate cancer based on blood protein markers, genetics and your medical history (if available). This means focused and potentially earlier treatment for those who need it and less unnecessary MRIs and biopsies for men who don’t. It’s important to note that the results of SK3 will not say whether you have prostate cancer, (only a biopsy can ultimately determine this), but it will provide your risk analysis.

Is SK3 a widely used and recognised test?

SK3 was developed 12 years ago and is approved by NICE (the UK National Institute for Health and Care Excellence)**. They say the evidence suggests that SK3 is more effective in predicting prostate cancer risk than PSA testing alone for men aged 45-74. SK3 is now used in health systems in Sweden, Norway, Finland and has recently been introduced in Germany, Switzerland and Turkey.

Who should consider screening?

Men aged 45-74 years onwards should consider prostate cancer screening. However, men with a higher risk of developing prostate cancer, such as those with a family history of the disease, may wish to begin screening earlier.

How much does the SK3 test cost?

The fee for the Stockholm3 test is £520.

This increases to £720 if a Urologist consultation is required to discuss results further.

What happens at the test?

A nurse will ask some medical history and two vials of blood are taken. The samples are sent to the laboratory in Stockholm and results can take 14 days. These are then shared at a follow-up appointment to discuss any next steps.

What happens if the screening test suggests a higher risk?

If a screening test suggests a higher risk of prostate cancer, we recommend further evaluation. We can write to your GP with details of the results, and arrange a referral to a Urologist if required.

A higher-risk result does not automatically mean you have prostate cancer – it suggests the need for additional investigation to make a definitive diagnosis.

**NICE, has published a report which highlights that the improved accuracy of SK3 has the potential to reduce unnecessary MRIs and biopsies and that implementation of SK3 could potentially reduce the overall costs of prostate cancer diagnosis in the UK.

What is Prostate Cancer?

Prostate cancer is a condition where abnormal cells grow in the prostate, a small gland that forms part of the male reproductive system. Prostate cancer is the most common cancer in the UK among men and usually shows no symptoms during its early stages. If detected early, prostate cancer can be treated and survival is highly likely.

Why is prostate cancer screening important?

Prostate cancer screening helps detect prostate cancer in its early stages when it is more manageable and treatable. The Stockholm3 test offers a modern approach to screening by combining genetic analysis with clinical and medical data. This enhances the accuracy of the screening process, reducing the number of unnecessary invasive diagnostic follow-up procedures.

What testing is available on the NHS for prostate cancer?

The NHS does not currently have a screening programme for prostate cancer in the UK, instead there is an informed choice programme called prostate cancer risk management that aims to give men information on the pros and cons of a Prostate Specific Antigen test (PSA).

The NHS uses guidance that if your PSA result is low or normal (dependent on age) you are deemed at low risk of developing prostate cancer. The problem is that 30-50% of aggressive prostate cancers can be found in men with low PSA values, while 70-80% of men with high PSA values do not have aggressive cancer but are still sent on for unnecessary treatment, such as an MRI scan to look for suspicious regions or lesions in the prostate. If the MRI detects lesions that could be cancerous, then a prostate biopsy is recommended. Biopsies are invasive, have side effects and risks, including the risk of getting a serious infection.

In summary:
 PSA misses 30-50% of all aggressive prostate cancers
 Many aggressive prostate cancers do not raise PSA
 Most men over age 60 will have one or more prostate cancer lesions but these will never develop to a prostate cancer that spreads beyond the prostate and would not require treatment