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Aftercare for prostate cancer survivors: information for General Practitioners in international guidelines.

Spronk, I., Schellevis, F.G., Korevaar, J.C. Aftercare for prostate cancer survivors: information for General Practitioners in international guidelines. Abstract. In: Abstract book 8th meeting of Ca-PRI 'The escalating cancer challenge - essential roles for primary care', 20-22 mei 2015, Aarhus. 11
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Background
The number of prostate cancer survivors requiring aftercare is rising. This places extra burden on hospital care. Therefore there are increasing appeals for greater involvement of General Practitioners (GPs) in the aftercare of prostate cancer survivors. To date, there is little structured information for GPs on the best way to provide aftercare.

Research question
What are relevant topics intended for GPs from existing guidelines on aftercare for prostate cancer survivors?

Methods
As part of CanCon (EU Joint Action Cancer Control), an inventory of international guidelines was undertaken. Internet and literature was searched and experts from the European Union Member States were approached to identify guidelines on aftercare for prostate cancer survivors. Relevant information for GPs was extracted and summarized in topics.

Results
So far, thirteen guidelines were included; three were specific on aftercare and two were specifically made for GPs. Ten relevant topics were identified. Most attention was paid to recurrence detection. All guidelines highlighted the importance of PSA testing. Agreement exists about the frequency of PSA testing; at least every six months for three years and thereafter (semi‐)annually. The majority of guidelines discussed digital rectal examination (DRE); however there is disagreement about its value. Few guidelines reported information on treatment of complications and only one mentioned health promotion for cancer survivors.

Conclusion
This inventory gives GPs a comprehensive view of evidence based guidance and opinion based advices on aftercare for prostate cancer survivors. Guidelines yielded several topics on aftercare. The main subject is the detection of cancer recurrence, including PSA testing, DRE and signs of recurrence. There is overall agreement on the value of PSA testing, but not on the use of DRE. Other important topics for GPs are: potential complications, treatment of complications, health promotion, psychological support, unnecessary diagnostic tests, organization of care and patient information.