dc.contributor.author | Merriel, SWD | |
dc.contributor.author | Funston, G | |
dc.contributor.author | Hamilton, W | |
dc.date.accessioned | 2018-08-29T13:05:29Z | |
dc.date.issued | 2018-08-10 | |
dc.description.abstract | Prostate cancer is a common malignancy seen worldwide. The incidence has risen in recent decades, mainly fuelled by more widespread use of prostate-specific antigen (PSA) testing, although prostate cancer mortality rates have remained relatively static over that time period. A man's risk of prostate cancer is affected by his age and family history of the disease. Men with prostate cancer generally present symptomatically in primary care settings, although some diagnoses are made in asymptomatic men undergoing opportunistic PSA screening. Symptoms traditionally thought to correlate with prostate cancer include lower urinary tract symptoms (LUTS), such as nocturia and poor urinary stream, erectile dysfunction and visible haematuria. However, there is significant crossover in symptoms between prostate cancer and benign conditions affecting the prostate such as benign prostatic hypertrophy (BPH) and prostatitis, making it very challenging to distinguish between them on the basis of symptoms. The evidence for the performance of PSA in asymptomatic and symptomatic men for the diagnosis of prostate cancer is equivocal. PSA is subject to false positive and false negative results, affecting its clinical utility as a standalone test. Clinicians need to counsel men about the risks and benefits of PSA testing to inform their decision-making. Digital rectal examination (DRE) by primary care clinicians has some evidence to show discrimination between benign and malignant conditions affecting the prostate. Patients referred to secondary care for diagnostic testing for prostate cancer will typically undergo a transrectal or transperineal biopsy, where a number of samples are taken and sent for histological examination. These biopsies are invasive procedures with side effects and a risk of infection and sepsis, and alternative tests such as multiparametric magnetic resonance imaging (mpMRI) are currently being trialled for their accuracy and safety in diagnosing clinically significant prostate cancer. | en_GB |
dc.identifier.citation | Published online 10 August 2018 | en_GB |
dc.identifier.doi | 10.1007/s12325-018-0766-1 | |
dc.identifier.uri | http://hdl.handle.net/10871/33842 | |
dc.language.iso | en | en_GB |
dc.publisher | Springer Verlag | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/30097885 | en_GB |
dc.rights | © The Author(s) 2018. Open Access. This article is distributed
under the terms of the Creative Commons
Attribution-NonCommercial 4.0 International
License (http://creativecommons.org/licenses/
by-nc/4.0/), which permits any noncommercial
use, distribution, and reproduction in any
medium, provided you give appropriate credit
to the original author(s) and the source, provide
a link to the Creative Commons license, and
indicate if changes were made. | en_GB |
dc.subject | Diagnosis | en_GB |
dc.subject | LUTS | en_GB |
dc.subject | Primary care | en_GB |
dc.subject | Prostate cancer | en_GB |
dc.subject | Prostate-specific antigen | en_GB |
dc.title | Prostate Cancer in Primary Care | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2018-08-29T13:05:29Z | |
exeter.place-of-publication | United States | en_GB |
dc.description | This is the final version of the article. Available from Springer Verlag via the DOI in this record. | en_GB |
dc.identifier.journal | Advances in Therapy | en_GB |