Low infection risk prostate cancer diagnostic tools approved for NHS use

The NHS must start using new diagnostic tools for prostate cancer that carry a lower risk of infection than methods.

Prostate cancer is the most diagnosed cancer in men in the UK according to Cancer Research UK. It mainly affects men over the age of 50, and the risk is higher for people of African descent and people with a family history of prostate cancer.

The National Institute for Health and Care Excellence (NICE) has approved four tests for NHS use which carry a lower risk of infection.

Currently, people with suspected prostate cancer undergo an MRI followed by a prostate biopsy for analysis. There are two ways to do a prostate biopsy. In a transrectal ultrasound-guided biopsy (TRUS), samples are taken using a biopsy needle inserted through the rectal wall via the anus.

However, TRUS can be associated with serious infections, sometimes requiring hospitalization and antibiotics.

NICE has now approved the use of transperineal biopsies under local anesthesia (LATP), where the needle enters the body through the perineum, the skin area between the anus and the scrotum.

A freehand needle positioning device can be used for LATP that attaches to the ultrasound probe to help target biopsy sampling and could significantly reduce the risk of biopsy-related sepsis compared to a TRUS biopsy.

Evidence presented to the committee suggested that cancer detection rates did not differ significantly between a TRUS biopsy and an LATP biopsy using a freehand needle positioning device.

Economic modeling has shown that LATP is also likely to be a cost-effective use of NHS resources.

Dr Mark Kroese, Chairman of NICE’s Diagnostic Advisory Committee, said: “People suspected of having prostate cancer can now have a different option when it comes to having a biopsy.

“The committee heard from patient experts who said they were concerned about not getting clear and accurate information about whether to undergo a biopsy, that they were concerned about an associated risk of infection, as well as the severity and duration of side effects.

“LATP using a freehand needle positioning device to perform a prostate biopsy should reduce unnecessary infections and therefore antibiotic use, to the benefit of both the patient and the NHS.”

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