- Health and well-being
Welcome to the next FICAN science webinar "Transforming Prostate Cancer Detection: Insights from Clinical Research in MRI and Screening".
Speaker: Antti Rannikko, MD, PhD, FEBU, Chief of Department at HUS Helsinki University Hospital, Department of urology and Professor of urology at the University of Helsinki.
This time the seminar is organized by FICAN South. The seminar will be held online (Microsoft Teams). The event is open to everyone interested in cancer research.
These nationwide webinars aim to
• share information about cancer research and its results conducted in various regions,
• provide insights into cancer care and diagnostics, with a focus on new approaches and techniques, and
• foster collaboration and discussion for the benefit of cancer patients throughout Finland.
Abstract
Prostate-specific antigen (PSA)–based screening has reduced prostate cancer mortality but at the cost of extensive overdiagnosis and overtreatment. Our research has aimed to transform prostate cancer detection by incorporating magnetic resonance imaging (MRI) and novel biomarkers into both clinical care and population-based screening.
In diagnostic pathways, we demonstrated that MRI-targeted biopsies detect more clinically significant cancers while reducing low-grade diagnoses, patient discomfort, and infectious complications compared with systematic biopsies. At the same time, we identified important caveats: interreader variability in MRI reporting, biopsy grade inflation, and overtreatment of MRI-detected Gleason grade group 2 cancers. Adding MRI to established risk models (CAPRA, MSKCC, Partin) improved prediction of adverse pathology and recurrence after surgery. Molecular and transcriptomic studies further revealed that MRI-visible lesions harbor aggressive features (e.g., FAP expression, PTEN loss), whereas invisible lesions are typically less aggressive. These findings on FAP have led to an ongoing clinical trial evaluating the performance of FAPI as a tracer in PET imaging of prostate cancer.
Most recently, in a multicohort registry study of over 6,000 men from Helsinki, Tampere, and Lille, we showed that PI-RADS score 5 is a strong independent predictor of prostate cancer–specific mortality and other key endpoints, while a negative MRI associates with negligible risk. These findings establish MRI not only as a diagnostic but also as a prognostic tool.
Building on this evidence, the Finnish ProScreen randomized trial combines PSA, a kallikrein panel, and MRI in a stepwise protocol. Early results suggest improved detection of high-grade cancers with reduced harms, moving us toward screening strategies that preserve mortality benefit while minimizing overdiagnosis.
For further information, please contact Maarit Sillanpää, email [email protected].
