Prostate cancer is on the rise among middle-aged and elderly men in China, but clinical care has faced challenges due to the lack of standardized guidelines and high-quality evidence. Despite several existing international and domestic guidelines, key areas—particularly the management of localized and metastatic prostate cancer—remain unclear. A new expert consensus aims to address these challenges and offer a unified framework for treating patients across the country.
Published on October 10, 2024, in the journal UroPrecision (DOI: 10.1002/uro2.76), the consensus results from extensive discussions and voting by leading experts in urology, medical oncology, and radiology. The document answers 19 critical questions about prostate cancer care, covering topics such as screening, biopsy techniques, and treatment for localized, advanced, and metastatic disease.
One of the most significant recommendations is for prostate-specific antigen (PSA) screening. The consensus strongly supports PSA testing, with 89% of experts agreeing that it can reduce prostate cancer-related deaths in China. Experts recommend starting screening at age 50 for men without a family history of prostate cancer or BRCA2 mutations.
In terms of treatment, the panel supports using next-generation hormonal therapies combined with androgen deprivation therapy (ADT) for patients with high-volume metastatic castration-sensitive prostate cancer. For nonmetastatic castration-resistant prostate cancer, 75% of experts suggest additional Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography/Computed Tomography (PET/CT) scans when traditional imaging fails to detect metastasis.
Dr. Nianzeng Xing, the corresponding author, noted that the consensus represents a major step toward standardizing prostate cancer management in China. “This consensus provides clinicians with a comprehensive reference for the entire patient journey, from screening to treatment and follow-up,” Xing said.
The document offers practical, evidence-based guidance to help Chinese clinicians navigate the complexities of prostate cancer. By addressing critical issues through expert consensus, it aims to improve patient outcomes and enhance the quality of life for those affected by the disease. These recommendations on screening and treatment are expected to significantly influence clinical practices nationwide, potentially reducing the disease burden and improving survival rates.
As the incidence of prostate cancer continues to rise, the expert consensus will play a crucial role in raising the standard of care and ensuring better management of the disease across China.
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