Consensus on Screening, Diagnosis, and Staging Tools for Prostate Cancer in Developing Countries: A Report From the First Prostate Cancer Consensus Conference for Developing Countries (PCCCDC)

Abstract

PURPOSE To generate and present the survey results on critical issues relevant to screening, diagnosis, and staging tools for prostate cancer (PCa) focused on developing countries. METHODS A total of 36 of 300 questions concern the main areas of interest of this paper: (1) screening, (2) diagnosis, and (3) staging for various risk levels of PCa in developing countries. A panel of 99 international multidisciplinary cancer experts voted on these questions to create recommendations for screening, diagnosing, and staging tools for PCa in areas of limited resources discussed in this manuscript. RESULTS The panel voted publicly but anonymously on the predefined questions. Each question was deemed consensus if 75% or more of the full panel had selected a particular answer. These answers are based on panelist opinion not a literature review or meta-analysis. For questions that refer to an area of limited resources, the recommendations consider cost-effectiveness and the possible therapies with easier and greater access. Each question had five to seven relevant answers including two nonanswers. The results were tabulated in real time. CONCLUSION The voting results and recommendations presented in this document can be used by physicians to support the screening, diagnosis, and staging of PCa in areas of limited resources. Individual clinical decision making should be supported by available data; however, as guidelines for screening, diagnosis, and staging of PCa in developing countries have not been developed, this document will serve as a point of reference when confronted with this disease.

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“…Therefore, patients, especially those with high-risk localised disease, must be made aware of the possibility of undiagnosed metastatic disease so they can make informed decisions about their treatment and manage their expectations about the course of their disease. In addition, healthcare providers should counsel these patients about the potential for cancer to spread without any evidence on traditional staging tests like bone scan, CT scan and MRI,[ 26 ] and the importance of regular follow-up after curative treatment. The availability of PSMA (prostate-specific membrane antigen) PET scans in West Africa may help reduce the incidence this problem.…”

Preservation of Proteins in Human Plasma through Metal–Organic Framework Encapsulation

“…Establishing organized prostate cancer screening has been challenging, in part because the assay of PSA is amenable to screening in central laboratories. Adequate PSA screening is important to identify affected individuals and allow timely interventions to avoid metastatic disease. , However, the broad applicability of screening is hampered by the dependence on cold chain-equipped clinics, especially in remote living or underserved and at-risk populations to get samples to the central laboratory for analysis. Since access to cancer screening tests in low- and middle-income countries − or for African Americans in general is beneficial, there is an urgent need to comprehensively evaluate existing and future cancer screening strategies to ensure benefit and control costs.…”