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This Week in the British Medical Journal: Apr 25, 2011


In the British Medical Journal this week, researchers in Sweden and Norway present the results of a 20-year follow-up of a randomized prostate cancer screening trial. More than 1,490 men in the city of Norrköping, Sweden were invited to be screened for prostate cancer every third year from 1987 to 1996 in order for the researchers to determine if prostate cancer screening reduces prostate cancer-specific mortality. After 20 years of follow-up, the researchers write, the rate of death from prostate cancer didn't differ significantly between the men in the screening group and those in the control group.

Also in the British Medical Journal this week, Grahame Howard and Moray Nairn present the updated Scottish Intercollegiate Guidelines Network, or SIGN, guidelines for the management of adult testicular germ-cell tumors. Testicular germ-cell tumors are rare, the authors write, but it is the 15th most common cancer in Scotland and the most common cancer in younger adult men. It is also curable, even after metastasis. SIGN's guidelines include advice for clinicians on the initial assessment and primary care of testicular tumors, referral to a specialist, management of the contralateral testis, management of metastatic disease, and treatment of relapsed disease. Because the treatment for testicular tumors is highly toxic, the guidelines also include advice on dealing with late toxicity and follow-up treatment. "The sections on management of stage I disease and of metastatic disease have been revised substantially," Howard and Nairn write. "Additions include new recommendations on use of prognostic scores to guide treatment for patients who relapse after first line platinum based chemotherapy, and new sections on radiological imaging for residual masses and on late toxicities after treatment with guidance for patients and general practitioners on symptom awareness."

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