A clinician survey on the current practices within the prostate cancer diagnostic pathway in the United Kingdom

Objectives: To assess current clinical practice of prostate biopsies among UK Urologists and Radiologists, to guide future strategy with regard to diagnostic studies. Methods: An online questionnaire was administered to 210 UK Urologists and Radiologists, between January 2020 and December 2020. Results: 124 responded (59%); urologists (55/77, 71.4%) and radiologists 22/77 (28.5%). 63/76 (83%) clinicians routinely use prebiopsy multiparametric magnetic resonance imaging (mpMRI) and 13/76 (17.1%) use bpMRI. For an MRI PI-RADS 1-2 score, 96% of clinicians would proceed to prostate biopsy with at least one additional risk factor. For an MRI PI-RADS 3 score, 48.6% would proceed to prostate biopsy with one additional risk factor, while 35.7% would perform a biopsy in all patients. 17.7% would proceed to prostate biopsy with a PSAD ⩽ 0.12 ng/mL/mL even in patients with a PI-RADS 1–2 lesion and 82.4% would for PI-RADS 3 lesions. Transperineal biopsies were most commonly performed (63/72, 88%). Up to nine systematic cores was most common (25/68, 36.8%) with three to four targeted cores (37%). 66/67 (98.5%) of clinicians would be willing to accept a standard operating procedure for participants in an RCT study (with regard to biopsy strategy). Conclusion: Our study has provided a glimpse into current UK practice to diagnose patients with prostate cancer and provides evidence for future RCT study designs.