Ultrasound-guided prostate biopsy in 2005

Abstract

Ultrasound-guided prostate biopsy may be performed by radiologists or urologists, and is now the commonest biopsy procedure undertaken in men. I suspect most readers will have a relative who has had a prostate biopsy. The article by Raja and colleagues give the reader a comprehensive review of many current issues related to contemporary diagnosis of this common tumour. Perhaps because it is so prevalent, there is now considerable interest in prostate cancer from politicians, the media and the public, and it is thus inevitable that medical practice in the diagnosis and management of prostate cancer is being scrutinized. In 2005, the National Institute for Clinical Excellence (NICE) announced a largescale review of the management of prostate cancer. The scope of this review is being finalized but it appears that this NICE review will concentrate on the management of proven cancer. Issues regarding the initial diagnosis of prostate cancer (such as prostate biopsy) will be outside the scope of the NICE study, and will be left by NICE to the Prostate Cancer Risk Management Programme (PCRMP). The PCRMP is a part of NHS Cancer Screening Programmes and is supported by a multi-disciplinary Scientific Reference Group. It has made considerable progress over the last 3 years in addressing issues related to prostate cancer diagnosis in England. The first area of interest that was studied was information about prostate-specific antigen (PSA) tests given to patients by general practitioners; an information leaflet was developed for primary care and its value has been studied. The second area of interest was quality issues of the PSA