Prostate Cancer Early Detection

Abstract

240The NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer Early Detection (to view the most recent version of these guidelines, visit the NCCN Web site at www.NCCN.org) provide a set of sequential recommendations detailing a screening and subsequent workup strategy for maximizing the detection of prostate cancer in an early, organconfined state and attempting to minimize unnecessary procedures. These guidelines were developed for men who have elected to participate in prostate cancer screening; they are not meant to address the controversy regarding population screening. OverviewProstate cancer is the most commonly diagnosed NCCN Categories of Evidence and ConsensusCategory 1: The recommendation is based on high-level evidence (e.g., randomized controlled trials) and there is uniform NCCN consensus. Category 2A: The recommendation is based on lowerlevel evidence and there is uniform NCCN consensus. Category 2B: The recommendation is based on lowerlevel evidence and there is nonuniform NCCN consensus (but no major disagreement). Category 3: The recommendation is based on any level of evidence but reflects major disagreement. Please NoteThese guidelines are a statement of consensus of the authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult these guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient's care or treatment. The National Comprehensive Cancer Network makes no representation or warranties of any kind regarding their content, use, or application and disclaims any responsibility for their applications or use in any way.These guidelines are copyrighted by the National Comprehensive Cancer Network. All rights reserved. These guidelines and the illustrations herein may not be reproduced in any form without the express written permission of the NCCN © 2010. Disclosures for the NCCN Prostate Cancer Early Detection Guidelines PanelAt the beginning of each NCCN guidelines panel meeting, panel members disclosed any financial support they have received from industry. Through 2008, this information was published in an aggregate statement in JNCCN and online. Furthering NCCN's commitment to public transparency, this disclosure process has now been expanded by listing all potential conflicts of interest respective to each individual expert panel member. cancer and the second leading cause of cancer death in American men. More than 192,000 men will be diagnosed with prostate cancer in 2009, and an estimated 27,360 men will die of this disease. 1During the same period, nearly 20 million men in the United States will be confronted with important decisions regarding early detection for prostate cancer. Men in the United States have an approximately 1 in 6 chance of eventually being diagnosed with this malignancy and about 1 in 30 chance of eventually dying of it.2 African-American men and men with a first-degree relative with prostate cancer (especially cancer fo...

Prostate-specific Antigen Velocity (PSAV) and PSAV per Initial Volume (PSAVD) for Early Detection of Prostate Cancer in Chinese Men

“…Therefore, PSAD should be considered in PCa detection, especially those who have had prior TRUS measurements of PV (Zheng et al, 2008;Kawachi et al, 2010). However, the optimal PSAD cutoff is still a controversy.…”

Should Bone Scan be Performed in Chinese Prostate Cancer Patients at the Time of Diagnosis?

“…PSA level at diagnosis and biopsy-derived Gleason scores are important predictors of BM. The National Comprehensive Cancer Network recommends that bone scan is appropriate for patients with T1-T2 disease who have a PSA of ≥20 ng/ml or a Gleason score of ≥8 [7] simultaneously. The European Association of Urology guideline indicates that a bone scan may not be needed in asymptomatic patients if the serum PSA is <20 ng/ml in the presence of well or moderately differentiated tumors [8].…”

Relative Value of Race, Family History and Prostate Specific Antigen as Indications for Early Initiation of Prostate Cancer Screening

“…2 A similar approach was taken by NCCN Guidelines®, which recommend starting screening earlier in black men and in men with a first-degree relative diagnosed with prostate cancer. 3 ACS (American Cancer Society) also recommends that age at screening initiation should be based on race and family history. 4 Similar recommendations are found in national guidelines outside the United States, including those in Australasia 5 and the United Kingdom.…”