Prostate cancer: active surveillance may prove organisationally impossible
- 68 Downloads
There is no gold standard for prostate cancer identification, investigation and treatments. Despite the recent practice conclusions of ‘no screening’ from the two randomised controlled trials of PSA screening, the volume of PSA estimations from primary care is very large. Active surveillance is an option for low-risk prostate cancers which are very common. Three issues immediately arise. The Irish incidence of prostate cancer is 156.4 per 100,000 per year and the death rate is 25.5 per 100,000 per year . In a population of 4.6 million people and growing, there will be about 7194 new cases per year with 80 % confined to the prostate only. As the population ages, the accumulation of prostate cancer cases will be very big. At age 65–69, the prostate cancer incidence is 560 per 100,000 .
Currently, there are 3267 new cases per year listed in the National Cancer Registry Ireland which is an under-ascertainment as the incidence rate in cases per 100,000 per year is listed...
KeywordsProstate Cancer Active Surveillance Early Prostate Cancer Prostate Cancer Prevention Trial Active Surveillance Protocol
- 3.National Cancer Registry Ireland. Cancer factsheet prostate. Updated December 2013. http://www.ncri.ie/sites/ncri/files/factsheets/FACTSHEET_prostate.pdf
- 5.Nice (National Institute for Health and Care Excellence). Guidelines [CG175] (2014). http://www.nice.org.uk/Guidance/CG175 (Accessed 20 Sept 2014)
- 6.Schroder FH, Hugosson J, Roobol MJ, For the ERSPC Investigators et al (2014) Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet 384(9959):2027–2035. doi: 10.1016/S0140-6736(14)60525-0 PubMedCentralCrossRefPubMedGoogle Scholar
- 8.Murphy DG, Ahlering T, Catalona EJ, Crowe H, Crowe J, Clarke N, Cooperberg M, Gillatt D, Gleave M, Loeb S, Roobol M, Sartor O, Pickles T, Wootten A, Walsh PC, Costello AJ (2014) The Melbourne Consensus Statement on the early detection of prostate cancer. BJU Int 113:186–188. doi: 10.1111/bju.12556 CrossRefPubMedGoogle Scholar
- 13.Azmi A, Dillon RA, Borghesi S, Dunne M, Power RE, Marignol L, O’Neill BD (2014) Active surveillance for low-risk prostate cancer: diversity of practice across Europe. Ir J Med Sci (Epub ahead of print)Google Scholar
- 15.Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, Minasian LM, Ford LG, Lippman SM, Crawford ED, Crowley JJ, Coltman CA Jr (2004) Prevalence of prostate cancer among men with a prostate-specific antigen level of ≤4.0 ng per millilitre. N Engl J Med 350:2239–2246CrossRefPubMedGoogle Scholar