Moderate hypofractionation is safe and effective , but longer-term data are still lacking .
Brachytherapy represents an effective way to increase the delivered dose .
OBJECTIVE To present a summary of the 2016 version of the European Association of Urology ( EAU ) - European Society for Radiotherapy & Oncology ( ESTRO ) - International Society of Geriatric Oncology ( SIOG ) Guidelines on screening , diagnosis , and local treatment with curative intent of clinical ly localised prostate cancer ( PCa ) .
EVIDENCE SYNTHESIS BRCA2 mutations have been added as risk factors for early and aggressive disease .
Systematic screening is still not recommended .
An early prostate-specific antigen test , the use of a risk calculator , or one of the promising biomarker tools are being investigated and might be able to limit the overdetection of insignificant PCa .
Breaking the link between diagnosis and treatment may lower the overtreatment risk .
Multiparametric magnetic resonance imaging using st and ardised reporting can not replace systematic biopsy , but robustly nested within the diagnostic work-up , it has a key role in local staging .
In Northern and Western Europe , the number of men diagnosed with PCa has been on the rise .
Prostate Needle Biopsy Outcomes in the Era of the U.S. Preventive Services Task Force Recommendation against Prostate Specific Antigen Based Screening.
PURPOSE We determined whether the characteristics of patients undergoing prostate needle biopsies and prostate needle biopsy results changed after the U.S. Preventive Services Task Force recommendation in 2012 against prostate specific antigen based screening for prostate cancer for men of any age . MATERIAL S AND METHODS A prospect i ve data base of patients undergoing prostate needle biopsies at Virginia Mason from 2004 to 2014 was review ed . Welch 's t-test and chi-square tests were used to compare patients seen before to those seen after the USPSTF recommendation . Relative risks and corresponding confidence intervals were estimated by general linear regression . RESULTS Patients in the post-USPSTF group ( 310 ) had a higher prostate specific antigen ( p < 0.001 ) , were more likely to be diagnosed with higher clinical stage ( 2b , p=0.003 ; 2c-3a , p=0.027 ) and D'Amico high risk prostate cancer ( p=0.036 ) , with an adjusted relative risk for high risk prostate cancer of 1.25 ( 95 % CI 1.02 - 1.52 ) compared to those in the pre-USPSTF group ( 1,416 ) . Limiting the pre-USPSTF group to the 30 months before the draft guidelines ( 448 patients ) yielded similar results . The absolute number of biopsies performed decreased by 31 % , with the majority of the decrease occurring in the detection of intermediate risk tumors . CONCLUSIONS In the 2 and a half years after the USPSTF recommendation against prostate specific antigen based screening , patients undergoing prostate needle biopsies were significantly more likely to be diagnosed with high risk disease . However , a reduction in the number of prostate needle biopsies performed occurred concomitantly with a decrease in the detection of intermediate risk , potentially curable prostate cancer . Future focus on informed application of screening techniques may prevent the reversal of decades of improvement in the prostate cancer mortality rate
Moderate hypofractionation is safe and effective , but longer-term data are still lacking .
Brachytherapy represents an effective way to increase the delivered dose .
OBJECTIVE To present a summary of the 2016 version of the European Association of Urology ( EAU ) - European Society for Radiotherapy & Oncology ( ESTRO ) - International Society of Geriatric Oncology ( SIOG ) Guidelines on screening , diagnosis , and local treatment with curative intent of clinical ly localised prostate cancer ( PCa ) .
EVIDENCE SYNTHESIS BRCA2 mutations have been added as risk factors for early and aggressive disease .
Systematic screening is still not recommended .
An early prostate-specific antigen test , the use of a risk calculator , or one of the promising biomarker tools are being investigated and might be able to limit the overdetection of insignificant PCa .
Breaking the link between diagnosis and treatment may lower the overtreatment risk .
Multiparametric magnetic resonance imaging using st and ardised reporting can not replace systematic biopsy , but robustly nested within the diagnostic work-up , it has a key role in local staging .
In Northern and Western Europe , the number of men diagnosed with PCa has been on the rise .