Recommendation ID

What is the most clinically and cost-effective follow‑up protocol for people with prostate cancer who have had radical treatment, with specific regard to risk stratification, duration of follow‑up, frequency of follow‑up appointments, the type of examination or blood tests, and the roles of primary and secondary care in follow‑up?

Any explanatory notes
(if applicable)

Why the committee made the recommendations

The committee saw no new evidence to suggest any changes were needed to the recommendations on follow‑up strategies after radical treatment. The committee did not change the existing recommendations that digital rectal examination should not be offered, as there was no new evidence to suggest it was beneficial for people who were not on active surveillance.

Based on their expertise, the committee amended the recommendations on the location of the follow‑up. The committee discussed different strategies already in use across the country such as shared care, supported self-management and telephone based follow‑up. Because it had not looked at the specific evidence for these, it was unable to recommend a specific programme. The committee agreed that the 2‑year follow‑up recommended in the previous guideline was conservative, and based on their expertise, people with no complications and with a stable PSA could be cared for outside of the hospital environment. Complex cases might need longer contact with hospital-based services.

Given the lack of evidence, the committee also made a research recommendation in this area.

How the recommendations might affect practice

The committee noted that follow‑up strategies are variable across the country and the recommendations will therefore have a varied resource impact across the country depending on the level of follow‑up that is currently in place locally. Depending on the changes implemented, there may be a large resource impact.

Full details of the evidence and the committee's discussion are in evidence review H: follow-up protocols after radical treatment.

Source guidance details

Comes from guidance
Prostate cancer: diagnosis and management
Date issued
May 2019

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 09/05/2019