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 .
Influence of blood prostate specific antigen levels at age 60 on benefits and harms of prostate cancer screening: population based cohort study
Objective To determine the relative risks of prostate cancer incidence , metastasis , and mortality associated with screening by serum prostate specific antigen ( PSA ) levels at age 60 . Design Population based cohort study . Setting General male population of Sweden taking part in a screening trial in Gothenburg or participating in a cardiovascular study , the Malmö Preventive Project . Participants The screened group consisted of 1756 men aged 57.5 - 62.5 participating in the screening arm of the Gothenburg r and omized prostate cancer screening trial since 1995 . The unscreened group consisted of 1162 men , born in 1921 , participating in the Malmö Preventive Project , with PSA levels measured retrospectively in stored blood sample s from 1981 . Intervention PSA screening versus no screening . Main outcome measures Incidence rate ratios for the effect of screening on prostate cancer diagnosis , metastasis , and death by PSA levels at age 60 . Results The distribution of PSA levels was similar between the two cohorts . Differences in benefits by baseline PSA levels were large . Among men with baseline levels measured , 71.7 % ( 1646/2295 ) had a PSA level < 2 ng/mL. For men aged 60 with PSA level < 2 ng/mL , there was an increase in incidence of 767 cases per 10 000 without a decrease in prostate cancer mortality . For men with PSA levels ≥2 ng/mL , the reduction in cancer mortality was large , with only 23 men needing to be screened and six diagnosed to avoid one prostate cancer death by 15 years . Conclusions The ratio of benefits to harms of PSA screening varies noticeably with blood PSA levels at age 60 . For men with a PSA level < 1 ng/mL at age 60 , no further screening is recommended . Continuing to screen men with PSA levels > 2 ng/mL at age 60 is beneficial , with the number needed to screen and treat being extremely favourable . Screening men with a PSA level of 1 - 2 ng/mL is an individual decision to be based on a discussion between patient and doctor
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 .