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EPAD 2017 - Nicolas Mottet


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Guidelines on PCa screening
Nicolas Mottet, Chairman EAU PCa Guidelines Panel

Published in: Health & Medicine
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EPAD 2017 - Nicolas Mottet

  1. 1. Guidelines on Prostate cancer screening N. Mottet St Etienne France
  2. 2. Prostate Cancer NOT an indolent disease 2nd / 3rd cause of cancer death Late clinical symptoms “Controversies” limiting the message
  3. 3. Difficulty Dying with a PCa / Dying from a PCa
  4. 4. EAU guidelines Endorsed by all EU member states scientific organisation And many others (altogether: 50 national urological associations) Fully published Updated yearly
  5. 5. EAU guidelines 2017 Evidence based (peer reviewed fully published papers) Mainly systematic revue Really multidisciplinary: 5 urologists, 3 radiotherapists, 2 medical oncologists, 1 pathologist, 1 radiologist, 1 patient representative
  6. 6. EAU guidelines Years of follow-up N needed to screen N needed to treat 9 1,410 48 11 979 35 13 781 27 ERSPC Schroeder Lancet 2014 PLCO trial: “control” arm at least as screened (if not more) as the “screened” arm Shoag. N Engl J med 2016 Numbers below those in breast cancer (Lancet 2012) Combined: screening reduces PCa mortality Tsodikov. Ann Int med 2017
  7. 7. EAU guidelines Still a question: diagnosis of “insignificant PCa” Knowing what happens is the only way to decide what to do Diagnosis does not mean treatment Diagnosis means: knowing what is present Leading to optimal decision General principle in Oncology: better outcome if early disease
  8. 8. EAU guidelines
  9. 9. EAU guidelines Early diagnosis: only way to find "early" aggressive lesions Cutting the link between diagnosis / treatment only way to decrease overtreatment while maintaining survival benefit associated with early diagnosis