Epidemiological research on prostate cancer at TUNI focuses on screening and etiology. We utilize the comprehensive Finnish population-based health care registries, and work closely with the Finnish Cancer Registry.
The Finnish randomized study of prostate cancer screening (FinRSPC) was the largest component of the European multicenter ERSPC trial with a common core protocol. The study population of FinRSPC includes all appr 80,000 men aged 55-67 at entry and residing in Helsinki or Tampere area (after exclusion of those with previous PrCa dg). Those randomized to the screening arm were invited for a PSA test three times at four-year intervals (except those aged above 71 years, diagnosed with PrCa or emigrated from the study area). Men in the control arm received no intervention. The trial covers >8000 PrCa cases and >500 PrCa deaths. Extensive analyses have been conducted on PrCa risk factors and outcomes of screening.
The population-based ProScreen screening trial was started in 2018 and aims to reduce prostate cancer mortality by early detection of clinically significant prostate cancer. It comprises all 61,000 male residents of Helsinki and Tampere aged 50-63 years. A quarter of them have been randomized to the screening arm, and the rest form the control arm. The screening interval is defined based on PSA at entry. The aim of the trial is to reduce overdiagnosis by employing three levels of screening (PSA, kallikrein panel and MRI) prior to diagnostic examination, while retaining a meaningful mortality reduction. The trial is carried out in collaboration with Helsinki University Hospital (Antti Rannikko, Kimmo Taari) and Tampere University Hospital (Teuvo Tammela) including radiology and pathology besides urology. Kallikrein panel analyses are performed by prof. Hans Lilja’s group in Malmö. A broad array of samples is also collected to a biorepository for developing and evaluating new biomarkers for clinically significant prostate cancer.
As a part of the ERSPC, we have shown that PSA-based screening can reduce prostate cancer mortality. The magnitude of effect in terms of relative risk reduction has remained stable across follow-up from 9 to 16 years (20%, or RR=0.8). hence, the absolute effect size has increased and at 16 years, it was 1.7 per 1000 men or one PrCa death was averted per 570 men invited for screening.
Nevertheless, a substantial increase in PrCa incidence indicates excess detection and overdiagnosis. At 16 years, incidence in the screening arm was 31 per 1000 men or one excess case per 34 men.
PCRC epidemiology group works primarily at the health sciences section on the 3rd floor of Arvo. We work closely with the biostatistics group led by prof. Jaakko Nevalainen, the Finnish Cancer Registry, prof. Teemu Murtola’s group on pharmacoepidemiology, and collaborate with urology departments in TAYS and HUS, as well as prof. Stephen Walter (McMaster). We are also involved in the PIONEER consortium (European Network of Excellence for Big Data in Prostate Cancer), which is an EU/IMI2 -funded project coordinated by the EAU with 32 partners in 9 countries.
Talala K, Heinävaara S, Taari K, Tammela T, Kujala P, Stenman UH, Malila N, Auvinen A. Long-term health-related quality of life among men with prostate cancer in the Finnish randomized study of screening for prostate cancer. Cancer Med 2020;9:5643-54
Pakarainen T, Nevalainen J, Talala K, Taari K, Raitanen J, Kujala P, Stenman UH, Tammela TLJ, Auvinen A. The number of screening cycles needed to reduce prostate cancer mortality in the Finnish section of the European Randomised Study of Prostate Cancer (ERSPC). Clin Cancer Res 2019;25:839-843
Hugosson J, Roobol MJ, Månsson M, Tammela TLJ, Zappa M, Nelen V, Kwiatkowski M, Lujan M, Carlsson SV, Talala KM, Lilja H, Denis LJ, Recker F, Paez A, Puliti D, Villers A, Rebillard X, Kilpeläinen TP, Stenman UH, Godtman RA, Stinesen Kollberg K, Moss SM, Kujala P, Taari K, Huber A, van der Kwast T, Heijnsdijk EA, Bangma C, De Koning HJ, Schröder FH, Auvinen A. 16-year follow-up of the European Randomised Study of Screening for Prostate Cancer (ERSPC). Eur Urol 2019;76:43-51
Booth N, Rissanen P, Tammela TL, Kujala P, Stenman U-H, Taari K, Talala K, Auvinen A. Cost-effectiveness of PSA-based mass screening: Evidence from the Finnish Randomised Study of Screening for Prostate Cancer after 20-year follow-up using register data. PLoS One 2019;14:e0224479
Auvinen A, Rannikko A, Taari K, Kujala P, Mirtti T, Kenttämies A, Rinta-Kiikka I, Lehtimäki T, Oksala N, Pettersson K, Tammela TL. A randomized trial of early detection of clinically significant prostate cancer (ProScreen): study design and rationale. Eur J Epidemiol 2017;32:521-527
Who we are?
Anssi Auvinen, MD, PhD, professor of epidemiology, PCRC director, Tampere University
Kirsi Talala, PhD, coordinator/researcher, Finnish Cancer Registry
Subas Neupane, PhD, post-doc, Tampere University/Health sciences
Aino Siltari, PhD, post-doc, Tampere University/University of Helsinki
Neill Booth, PhD, post-doc, health economics, Tampere University/Health sciences
Kari Natunen, MSc, trial coordinator, Tampere University/Health sciences
Tomi Pakarainen, MD, PhD, post-doc, Tampere University Hospital
Jani Raitanen, MSc, statistician, Tampere University/Health Sciences
Lasse Saarimäki, MD, PhD researcher
Dimitri Pogodin-Hannolainen, MD, PhD researcher, Tampere University Hospital
Mare Leht, MD, PhD researcher, Tampere University Hospital
Kimmo Kemppainen, MD, Tampere University/Health sciences
Pete Kinnunen, MD, PhD researcher, Tampere University/MET
Jukka Salminen, MD, PhD researcher, Tampere University/MET
Ville Vihervuori, MD, PhD researcher, Tampere University/MET
Arla Vettenranta, BMed, PhD student, Tampere University/MET
Veera Soronen, BMed, Tampere University/MET
Bilal Sumrein, MD, PhD researcher, Tampere University Hospital