2019BC指南：基层医疗中前列腺癌的诊断，推荐以及随访（草稿）.pdf

DRAFT Prostate Cancer: Diagnosis, Referral and and Follow-up in Primary Care DRAFT FOR EXTERNAL REVIEW - The online questionnaire is available at .bc.ca/prostate Scope This guideline provides recommendations for primary care providers, for the investigation and management of adult male patients (≥19 years of age) who present with signs or symptoms that could lead to a diagnosis of prostate cancer. Transgender prostate cancer care is an emerging topic that is beyond the scope of this guideline.1,2 Refer to the TransCare BC Primary Care Toolkit and BC Cancer recommended resources. Recommendations include clinical assessment, the management of prostate specific antigen (PSA) test results, and the appropriate referral of the patient to a specialist. This guideline also addresses follow-up after treatment, and post-treatment management including the numerous side effects associated with the treatment of prostate cancer, as well as how to detect and refer cases of possible recurrence. Currently there is a lack of strong evidence to support unselected, population-wide PSA testing for prostate cancer screening because of the potential for overdiagnosis, overtreatment, and detriment to quality of life. (Refer to Controversies in Care, below). However, men often present in primary care with questions about PSA testing and guidance is included for primary care practitioners to support conversations about the harms and benefits of PSA testing for asymptomatic men. The assessment and referral of asymptomatic men presenting with an elevated PSA test result is also addressed. This guideline was developed in collaboration with the BC Cancer Primary Care Program (Family Practice Oncology Network), and was developed based on a guideline adaptation approach, including a recent systematic review of the evidence. Adapted recommendations were ba