Prostate cancer: diagnosis and management

Cancers insufficiently researched in primary care: Observational studies of symptomatic primary care patients should be used to estimate the positive predictive value of different symptoms for specific cancers. Priority areas for research are those where the evidence base is currently insufficient and should include prostate cancer, pancreatic cancer, cancer in childhood and young people and other rare cancers. Outcomes of interest are positive predictive values and likelihood ratios for cancer.

What is the most suitable surveillance protocol (including the role of digital rectal examination [DRE] and prostate-specific antigen [PSA] measures) for people for whom active surveillance is appropriate, as assessed by multiparametric MRI and biopsy, when there are no clinical concerns during follow‑up?

What is the most clinically and cost-effective follow‑up protocol for people with prostate cancer who have had radical treatment, with specific regard to risk stratification, duration of follow‑up, frequency of follow‑up appointments, the type of examination or blood tests, and the roles of primary and secondary care in follow‑up?

What is the most clinically and cost-effective pathway for diagnosing clinically significant prostate cancer?

What is the most clinically and cost-effective pathway for diagnosing clinically significant prostate cancer?

What is the natural history of people with a Likert score on MRI of less than 3 without biopsy at long-term follow‑up?

Staging investigations for CPG 3 prostate cancer: What is the diagnostic accuracy of staging investigations for CPG 3 prostate cancer?

What is the prognostic value of different risk stratification methods for people with locally advanced prostate cancer?

In patients with negative MRI (Likert score 1 or 2), what is the next best diagnostic investigation to rule out clinically significant prostate cancer?

What is the diagnostic accuracy of transperineal mapping biopsy compared with transperineal non-mapping biopsy in the diagnosis of clinically significant prostate cancer?

What is the effectiveness and cost effectiveness of different scheduling of zoledronic acid in the prevention and reduction of skeletal events in people with hormone-refractory prostate cancer?