Prostate cancer

Screening for prostate cancer decreases the risk of metastatic disease at 12 years follow up.

In an article by Shroder et al published in Europe Urol (2012), the authors publish results from the European randomised study of screening for prostate cancer. They report that screening significantly reduces the risk of developing metastatic disease in the 76813 men with available data. At 12 years follow up 256 screened men and 410 control men had developed metastasis. This was a relative risk reduction of 30% or 3.1 per 1000 men randomised (42% in the intention to screen analysis).

Screening for prostate cancer using the PSA blood test remains amongst the most controversial subject in Urology, but this data adds significantly to the body of evidence supporting screening.

Positive margin rates after radical prostatectomy are under half the national average

Positive margin rates (PSM) after radical prostatectomy performed by Christopher Luscombe of the Staffordshire Urology Clinic have been consistently about 15% over the last 5 years. This compares with a national average of 38% reported in an article in the medical journal British Journal of Urology International last month. The article describes research carried out on the British Association of Urological Surgeons complex procedures database; a database that all Urology Consultants in the UK are encouraged to report details of operations that they perform to. PSM are associated with a much higher rate of cancer recurrence after radical prostatectomy, although many men are still cured even with a PSM, and the lower the rate the better. Our PSM results of only 15% are taken from this database and our further analysis of this database for operations performed in the last 5 years shows that a PSM rate of only 15% is the lowest in the Midlands, although reporting by many surgeons is not comprehensive.

National results from this database for 2012 have just been published (click here).