Research Square · Oct 18, 2026

Key performance indicators for organized risk stratified prostate cancer screening in Europe: first results from the PRAISE-U and EUCanScreen pilots and the Swedish organised prostate cancer testing programme

By Chandran A, Singh D, Harten MJv et al.

Background. Prostate cancer (PCa) is the most frequently diagnosed cancer in men in the European Union. Following the 2022 Council Recommendation to evaluate organised screening based on prostate-specific antigen (PSA) testing and magnetic resonance imaging (MRI), PRAISE-U defined 21 harmonised key performance indicators (KPIs). We report their first empirical values from the five PRAISE-U pilots and, through a common survey, from EUCanScreen pilots and the Swedish organised prostate cancer testing (OPT) programme. Methods. In PRAISE-U, men aged 50–69 years at five pilot sites in Spain, Lithuania, Poland and Ireland were invited to risk-stratified screening comprising PSA testing, first-level risk stratification, MRI for intermediate or high risk and selective biopsy, with prospective capture in a central REDCap database. EUCanScreen pilots and the Swedish organised prostate cancer testing (OPT) programme reported the same KPIs through an online survey. Results. Twelve programmes reported KPI values. Across the five PRAISE-U pilots, participation ranged from 7.1% to 43.0%, PSA exceeded 3 ng/ml in 9.2–15.0%, and compliance was 76.4–96.0% for first-level risk assessment, 89.9–98.3% for MRI and 78.9–99.0% for biopsy. Detection ranged from 8 to 26 per 1,000 screened in PRAISE-U and from 4.3 to 28 across all programmes. ISUP grade 1 accounted for 20.3–81.4% of cancers, active-surveillance uptake for 14.8–100%, and mean time from PSA result to MRI for 19–114 days; external values fell broadly within the PRAISE-U ranges. Thirteen of 21 KPIs were fully reported by all five pilots, all describing the diagnostic pathway; retention and the three impact indicators were reported only by Sweden, which reported 19 of 21. Conclusions. Diagnostic-pathway KPIs were measurable under pilot conditions, whereas programme-level indicators required a defined target population or registry linkage. Sweden, the only population-based programme, reported retention and long-term impact, identifying the infrastructure needed before organised PCa screening can be monitored at scale.

doi.org/10.21203/rs.3.rs-11244507/v1 Open access Interventions