GIRFT guidance aims to improve diagnosis and treatment times for men with suspected prostate cancer

Best practice guidance to help improve the care of patients with suspected prostate cancer is now available to NHS colleagues in a new Getting It Right First Time (GIRFT) resource.

The practical guidance, supported by the British Association of Urological Surgeons (BAUS) and the British Association of Urological Nurses (BAUN), includes a delivery checklist and detailed principles for first-class care across the entire patient pathway – from primary care to secondary care to ongoing monitoring, as well as recommendations for managing biopsies and treatment choices.

Towards Better Diagnosis & Management of Suspected Prostate Cancer has been developed by an expert working group of 20 clinicians to ensure representation across the whole pathway.

Best practice recommended in the guidance aims to speed up the time to diagnosis and treatment, at the same time as reducing unnecessary tests. For example, in primary care the guidance acknowledges that men at higher risk (aged 50 or Black men over 45) can have a prostate-specific antigen (PSA) test after discussion of prostate cancer risk, with no digital rectal examination (DRE) needed if the PSA is raised. In secondary care, it recommends that patients who are fit for radical treatment should go direct to MRI and then have a review with the clinical team with the MRI result, helping to reduce delays to diagnosis and treatment if required.

More than 52,000 men are diagnosed with prostate cancer every year in England, and around 1 in 8 will get it in their lifetime. Prostate cancer is not always life-threatening, but the earlier it is diagnosed the more likely the patient will be cured. Prostate cancer mainly affects men over 50, and the risk increases with age.

The GIRFT working group behind the guidance was led by Professor Caroline Moore, NIHR research professor at University College London and honorary consultant urological surgeon at University College London Hospitals NHS Foundation Trust.

"Existing evidence and guidance defines aspirational standards for diagnosing, managing and supporting patients with cancer. However, inevitably, there are gaps in such guidelines when it comes to defining how first-class clinical services should function. We hope that the principles and practicalities we’ve described will support multidisciplinary teams across the NHS addressing the challenges in delivering improved outcomes and experiences for patients with prostate cancer.”

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