{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:45:47Z","timestamp":1791866747350,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002794","name":"Cancerfonden","doi-asserted-by":"publisher","award":["22\u20102041"],"award-info":[{"award-number":["22\u20102041"]}],"id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2020\u201002477"],"award-info":[{"award-number":["2020\u201002477"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess whether prostate\u2010specific antigen density (PSAD) stratifies long\u2010term risk of clinically significant prostate cancer (csPCa) after a negative magnetic resonance imaging (MRI; Prostate Imaging\u2010Reporting and Data System score \u22642) and to evaluate the potential of PSAD to guide follow\u2010up in a screening setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>\n                      This pre\u2010specified sub\u2010analysis of the population\u2010based, randomised G\u00f6teborg\u20102 screening trial included 1685 men who underwent PSA testing between October 2015 and June 2021 and had a subsequent negative initial MRI. Follow\u2010up continued until 30 September 2024. The primary endpoint was cumulative incidence of csPCa (Gleason score \u22653\u2009+\u20094). Men were categorised by baseline PSAD (&lt;0.10, 0.10 to &lt;0.15, and \u22650.15\u2009ng\/mL\n                      <jats:sup>2<\/jats:sup>\n                      ). Cumulative incidence was estimated using Kaplan\u2013Meier methods and compared using the log\u2010rank test. The clinical implications of PSAD\u2010based follow\u2010up strategies were explored.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over a median follow\u2010up of 5.5\u2009years, 160 PCas were diagnosed, of which 80 were csPCa, including 22 cases of Gleason score \u22654\u2009+\u20093. At 7\u2009years, cumulative csPCa incidence was 7.1% overall and 5.5%, 13.8%, and 11.9% in the PSAD &lt;0.10, 0.10 to &lt;0.15, and \u22650.15\u2009ng\/mL\n                      <jats:sup>2<\/jats:sup>\n                      groups, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001 for PSAD &lt;0.10\u2009ng\/mL\n                      <jats:sup>2<\/jats:sup>\n                      vs both higher groups). Overall, 87% of repeat MRIs remained negative. Although men with baseline PSAD &lt;0.10\u2009ng\/mL\n                      <jats:sup>2<\/jats:sup>\n                      had the lowest overall risk, 42 csPCas occurred in this group, including 12 Gleason score \u22654\u2009+\u20093, emphasising the importance of continued regular PSA\u2010based follow\u2010up. A PSAD\u2010guided strategy with biennial PSA testing and repeat MRI triggered by PSAD \u22650.10\u2009ng\/mL\n                      <jats:sup>2<\/jats:sup>\n                      could reduce MRI use by 60% and biopsies by 46%, halve detection of clinically insignificant PCa, and delay csPCa diagnosis in 17% of cases including 10 men with Gleason score 3\u2009+\u20094 and one with Gleason score \u22654\u2009+\u20093.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The PSAD stratifies long\u2010term risk of csPCa after a negative MRI and supports risk\u2010adapted follow\u2010up in PCa screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70450","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:03:56Z","timestamp":1789776236000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The role of\n                    <scp>PSA<\/scp>\n                    density in the follow up of men with a negative\n                    <scp>MRI<\/scp>\n                    in the G\u00f6teborg\u20102 trial"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7969-4328","authenticated-orcid":false,"given":"Fredrik","family":"M\u00f6ller","sequence":"first","affiliation":[{"name":"Department of Urology, Institute of Clinical Science Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Urology Skaraborg Sk\u00f6vde Hospital, Region V\u00e4stra G\u00f6taland  Sk\u00f6vde 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Clinical Sciences Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Radiology Sahlgrenska University Hospital, Region V\u00e4stra G\u00f6taland  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Spyratou","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Clinical Science Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Pathology Sahlgrenska University Hospital, Region V\u00e4stra G\u00f6taland  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4295-6524","authenticated-orcid":false,"given":"Johan","family":"Stranne","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Clinical Science Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Urology Sahlgrenska University Hospital, Region 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