Once again the Scottish Cancer Prevention Network has invited members, colleagues and regular SCPN newsletter contributors to recommend what they have been reading on cancer prevention during 2016. We’ve asked each one to recommend the paper they thought would be most valuable to share. Our final paper of the year has been nominated by Prof Bob Steele, Clinical Director, Scottish Bowel Screening Programme and our very own co-director.
Title: 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer.
Authors: Hamdy FC Donovan JL, , Lane JA et al.
New England Journal of Medicine (2016) 375 (15) 1415-14254
Why is this paper important?
Radical surgery for prostate cancer carries a very high morbidity and as 27 men need to be treated to prevent one cancer death from PSA Screening, this has inhibited the introduction of prostate cancer screening. The PROTECT Study has attempted to address this problem by a three way randomisation between radical surgery, radiotherapy or active monitoring with treatment restricted to those experiencing a rise in PSA. After a median of 10 years of follow-up there was no difference between the three groups in prostate cancer mortality or death from any cause.
Main take home messages
This is an extremely important study as it addresses one of the main barriers to screening i.e. the perceived need for immediate radical treatment in all PSA-detected cases of prostate cancer. There is one important caveat however, those managed by active monitoring did have a higher rate of metastatic disease and with more prolonged follow-up it may be that those treated at the time of initial diagnosis will have a better outcome.
We’ll be sharing Papers of the Year throughout December – keep an eye out on our Twitter feed for more updates. Each of the papers will be available here as they are posted.