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- Title
General application of the National Institute for Health and Clinical Excellence (NICE) guidance for active surveillance for men with prostate cancer is not appropriate in unscreened populations.
- Authors
Wong, Lih-Ming; Johnston, Richard; Sharma, Naomi; Shah, Nimish C; Warren, Anne Y; Neal, David E
- Abstract
Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Active surveillance (AS) is a well-recognised management strategy to minimise the morbidity associated with radical treatment of prostate cancer. The National Institute for Health and Clinical Excellence guidelines initially suggested that all men with low-risk prostate cancer should first be offered AS. The cohort of men with upstaging and upgrading of prostate cancer from diagnosis to final pathology has been described in North American and European populations. As the rate of PSA testing in Britain is lower than North America and parts of Europe, the risk of more advanced disease at diagnosis of prostate cancer is higher. The present study is one of the first to examine this cohort in a British population and found the rate of features of advanced disease (extracapsular extension, seminal vesicle involvement and Gleason 4 + 3, or 8-10) to be 37.2%.
- Publication
BJU international, 2012, Vol 110, Issue 1, p24
- ISSN
1464-410X
- Publication type
Journal Article
- DOI
10.1111/j.1464-410X.2011.10730.x