NICE prostate cancer clinical guideline: implications for primary care

摘要

Prostate cancer is the commonest cancer in men, with 32 000 new cases annually. Its incidence is increasing, largely as a result of an increase in prostate specific antigen (PSA) testing over the last two decades.1 However prostate cancer deaths are relatively stable at 10 000 deaths a year, suggesting that the increase in PSA tests has resulted in more diagnoses of early-stage disease whose treatment does not have a significant impact on mortality. It is a disease of older age, being rare in under 50s, with a peak prevalence in the seventh decade.1 Prostate cancer has a variable natural history, with many cancers remaining relatively indolent and causing few, if any, clinical problems, and others running a more aggressive course. This has led to difficulties and uncertainties in evaluating the effectiveness and cost-effectiveness of both treatments, and monitoring protocols, for various forms of the disease.