Prostate cancer: summary of updated NICE guidance

Prostate cancer poses a major health problem in many countries and is the commonest cancer in men in the UK.1 Its incidence and mortality rate are higher in men of African-Caribbean origin. Since publication of the original NICE guideline in 2008,2 there have been several changes in diagnosis and management of prostate cancer. Great improvements in the treatment of hormone relapsed metastatic disease with the introduction of several new treatments (cabazitaxel, abiraterone, enzalutamide, and radium-223) have been assessed by NICE’s Technology Appraisal Programme3 4 and are not covered by this guidance. This article summarises recently updated recommendations from the National Institute for Health and Care Excellence (NICE) on the diagnosis and care of men with prostate cancer.5 Many recommendations have not been updated from the previous guidance and can be found in a previous BMJ summary.6 NICE recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Information and support for patients ### Initial assessment and diagnosis