Men with a serum PSA of >3.0 ng/ml are typically referred for further diagnostic investigations for prostate cancer; however, many either will not have the disease or will have low-risk tumours and might have adverse events from unnecessary diagnostic procedures and/or overtreatment. Now, an update from the ongoing GÖTEBORG-2 study demonstrates that men without suspicious lesions detected on MRI of the prostate can safely forego further diagnostic procedures.

In GÖTEBORG-2, a total of 13,153 men 50–60 years of age are undergoing serum PSA monitoring at 2, 4 or 8 years after initial testing depending on baseline results, with a serum PSA of >3.0 ng/ml at any round of testing as the threshold for further investigation. These men were randomly allocated 1:1 to undergo prostate MRI followed by systematic biopsy sampling regardless of MRI findings versus only targeted biopsy sampling if suspicious lesions were detected on MRI. Detection of clinically insignificant (International Society of Urological pathology (ISUP) grade 1) prostate cancer was the primary end point. Detection of clinically significant (ISUP grade ≥2) prostate cancer was a secondary end point.

血清 PSA 为 >3.0 ng/ml 的男性通常被转诊进行前列腺癌的进一步诊断检查;然而，许多人要么不会患有这种疾病，要么患有低风险肿瘤，并且可能会因不必要的诊断程序和/或过度治疗而发生不良事件。现在，正在进行的哥德堡 2 号研究的更新表明，在前列腺 MRI 上没有检测到可疑病变的男性可以安全地放弃进一步的诊断程序。

在哥德堡 2 号中，共有 13,153 名 50-60 岁的男性在初始测试后 2、4 或 8 年接受血清 PSA 监测，其中血清 PSA 为 >3.0 ng/ml在任何一轮测试中作为进一步调查的阈值。这些男性被随机分配 1：1 接受前列腺 MRI，然后进行系统活检取样，而不考虑 MRI 结果，如果 MRI 检测到可疑病变，则仅进行靶向活检取样。检测临床意义无统计学意义的 （国际泌尿外科病理学会 （ISUP） 1 级） 前列腺癌是主要终点。检测具有临床意义的 （ISUP ≥2 级） 前列腺癌是次要终点。