Prague Prostaforum 2022 declaration for improving prostate cancer early detection in Europe

Drafting team: Ondřej Májek, Marek Babjuk, Monique Roobol, Ola Bratt, Hendrik Van Poppel, Roman Zachoval, Marcela Koudelková, Ondřej Ngo, Karel Hejduk, Ladislav Dušek

Prague, 24 November2022

During a meeting in September 2022, the Ministers of Health of the European Union expressed their support for the Call to Action on Oncology, which was the main output from the Modern Cancer Control: Saving Lives Through Smart Solutions expert conference on oncology, which called on all stakeholders to consider support of EU-wide accessibility of quality cancer screening programmes [1].

Prostate cancer is the most frequently occurring male cancer in many European countries and one of the most common causes of cancer death among men. Estimated prostate cancer incidence rates varied twofold and mortality rates threefold in 2020 across the EU [2]. Detection of prostate cancer at an early stage, when treatment is less invasive and more likely to be effective, could significantly reduce mortality and the incidence of advanced prostate cancer with serious impacts on quality of life among European men. According to the evidence review report produced by the Science Advice for Policy by European Academies body for the European Commission [3], there is good evidence that prostate cancer screening with PSA testing reduces deaths from prostate cancer. While overdiagnosis and overtreatment are major harms in prostate cancer screening, use of an upper age limit, including risk stratification after baseline PSA, high-quality MRI scanning, and other complementary tests will significantly reduce overdiagnosis and improve the harm-to-benefit ratio.

Taking the above-mentioned considerations into account, the Prostaforum declaration calls on all stakeholders to consider and support the following steps specifically for prostate cancer control through early detection:

  • Adopt and implement in a timely and ambitious manner the new council recommendation on cancer screening to promote EU-wide state-of-the-art provision of evidence-based cancer screening.

  • Make available in a timely manner new technologies for early detection of prostate cancer.

  • Investigate these new technologies in screening algorithms applied to population-based screening programmes.

  • The European Commission should promote the development and implementation of European guidelines and quality assurance schemes for prostate cancer screening through a European initiative on prostate cancer, so that countries can adhere to the best evidence-based recommendations, while at the same time recognising their local circumstances and resource constraints, among other factors.

  • The European Commission should consider the possibility of supporting collaborative efforts to implement actions to support early detection of prostate cancer at the national level, including health literacy and raising of awareness.

  • The European Commission, together with member states with reference to their national context, should make every effort to reduce the striking differences between EU countries in the burden of prostate cancer.

  • Structured sharing of good practices in prostate cancer screening and early detection among EU countries, including timely sharing of data on agreed quality assurance indicators and the results of implementation/pilot studies, should be further strengthened.

  • Support all stages of research (preclinical → clinical → implementation → outcomes) aimed at improving prostate cancer screening and early detection as measures to decrease the striking differences in prostate cancer mortality between EU member states.

  • The Prague Prostaforum 2022 declaration has been endorsed by (as of 1/6/2023):
    • European Association of Urology (C. R. Chapple)
    • Czech Urological Society
    • Ministry of Health of the Czech Republic
    • Institute for Health Information and Statistics of the Czech Republic
    • Slovak Urological  Society (Ivan  Minčík)
    • Deutsche Gesellschaft für Urologie (Holger Borchers)
    • Arnulf Stenzl, MD, Prof., Interuniversitary Centre for Medical Technology Stuttgart
    • Steven Joniau (Belgian Genito-Urinary School)
    • Peter Dekuyper (Belgian Laparoscopic Urology Group)
    • Ángel Borque-Fernando (Hospital Universitario Miguel Servet, IIS-Aragon)
    • Jose Manuel Ramirez Garcia (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado)

    • Ahmed Said Zribi
    • Davide Maffei (Humanitas University)
    • Isabelle Bußhoff  (Uniklinikum Düsseldorf)
    • Alexander Minich (N.N. Alexandrov National Cancer Centre)
    • Marius Kincius (National Cancer Institute Vilnius)
    • Alejandro Sanz Ruiz (Hospital de Leon)
    • Hellenic Urological Association (Gerasimos Alivizatos)
    • Polish Urological Association (Tomasz Drewa)
    • Association of Austrian Urologists (Mehmet Özsoy)
    • Kosovo Association of Urology (Bujar Frangu)
    • Société Belge d’Urologie (Peltier Alexandre)
    • French Urology Association (Pr A de la Taille)
    • Estonian Urological Society (Martin Kivi)
    • German Society for Urology (Martin Kriegmair)
    • Association Française d'Urologie (Yann Neuzillet)
    • Georgian Urological Association (Archil Chkhotua)
    • Dutch Urological Association (Bart van Bezooijen)
    • Belgian Association of Urology (Karel Decaestecker)
    • Ukranian Association of Urology (Oleksandr Shulyak)
    • Croatian Society of Urology (Igor Tomaskovic)
    • Society of Urological Surgery in Turkey (Hasan Serkan Dogan)
    • Bulgarian Association of Urology (Marin Georgiev)
    • Serbian Association of Urologists and Urooncologist (Aleksandar Vuksanovic)
    • EuropaUOMO (Guenther Carl)
    • Swedish National Working Group for Organised Prostate Cancer Testing (Ola Bratt)
    • Association of Prostate Cancer Support Groups in Hesse (Günter Feick)
    • Asociace mužů sobě z.s. (Josef Franěk)
    • Romain Boissier, Aix-Marseille University
    • Günter Niegisch
    • Philippe Barthelemy, Institut de Cancérologie Strasbourg
    • Arnulf Stenzl, Eberhard-Karls-University, Tuebingen
    • Laurent Brureau, University Hospital of Guadeloupe
    • Piotr Lukasz Rutkowski
    • Nicolas Doumerc, CHU Toulouse
    • Roumiguie Mathieu, CHU Toulouse
    • Gert De Meerleer, Leuven University Hospitals
    • Clémence Lachambre, CHU Amiens
    • Camille Duport
    • Pauline Roulette, CH Cahors
    • Benjamin Branchu, Clinique Trenel France
    • Richard Seret, CHU de Reims
    • Arnaud Bracq
    • Priscilla Leon, Clinique Pasteur Royan
    • Peter Albers, Düsseldorf University, German Cancer Research Center, Heidelberg
    • Pierre Bigot
    • Charles Dariane, Georges-Pompidou European Hospital
    • Antoine van Hove, Hôpital Europeen Marseille
    • Caroline Pettenati, Hopital Foch, Institut hospitalier Franco-Britannique
    • Roumiguie Mathieu, CHU Toulouse
    • Gaelle Fiard / Grenoble Alpes University Hospital, Grenoble
    • Roupret Morgan, APHP Sorbonne University Pitié Salpêtrière
    • Karel Decaestecker, AZ Maria Middelares
    • Barry Jones, RCSI NorthEast
    • Boris Kollarik
    • Jens Rassweiler, Danube Private University
    • Axel Merseburger
    • Monique Roobol, Erasmus University Medical Center
    • Monika Daňová

Support of the Prague Prostaforum Declaration