Work

Cohort profile: the Prostate-Specific Antigen Cohort (PSA Cohort) and the Prostate Cancer Risk Cohort (ProCaRis Cohort) - cohorts based on Danish health data

Year: 2026

Type: article

Abstract: Purpose In many countries, prostate cancer (PCa) is the most frequent cancer in men and current testing strategies using prostate-specific antigen (PSA) are heavily debated. To advance our understanding of PSA testing, we established two Danish register-based cohorts. These cohorts provide a unique opportunity to investigate PSA testing practices and the potential benefit of incorporating a genetic risk assessment into PSA-based screening programmes. Participants We established a PSA cohort including 68 740 men with a first PSA test between the years 2012 and 2018 and an age-matched comparison cohort of 6 87 400 men from the general population, with no PSA test at the time of matching. We further established a cohort of men with a genetic PCa risk assessment in connection with a PSA test between the years 2012 and 2018—the Prostate Cancer Risk (ProCaRis) cohort, comprising 3902 men. The genetic test was offered by general practitioners as part of a cluster-randomised trial. Findings to date The cohorts include a wide range of variables retrieved from high-quality Danish registers, covering both clinical and socioeconomic factors. We found that the PSA cohort generally included men with higher comorbidity and medication use compared to the age-matched cohort. In contrast, the ProCaRis cohort represented a selected cohort of men with higher socioeconomic position and low comorbidity, except for including a high proportion of men with benign prostatic hyperplasia. These differences should be recognised in future studies as they could represent potential sources of bias. Future plans The PSA cohort and the ProCaRis cohort represent valuable resources for future studies of PSA testing and genetic risk assessments in routine clinical practice. Currently, the PSA cohort is being used to study PSA testing and subsequent risk of PCa. Once permission is granted, the follow-up time can be updated and additional variables can be linked at the individual level. Trial registration number NCT01739062.

Source: BMJ Open

DOI: 10.1136/bmjopen-2026-125507