ERSPC Section: Belgium (Antwerp)

belgium

Location:

Oncologisch Centrum Antwerpen
Lange Gasthuisstraat 45
2000 ANTWERPEN
BELGIUM

Contact address:

Mrs. Dourcy-Belle-Rose
Oncologisch Centrum Antwerpen
Lange Gasthuisstraat 45
2000 Antwerpen
BELGIUM

Tel +32-3-338.91.54
brigitte.dourcy-belle-rose@ocmw.antwerpen.be

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Project leader: Louis Denis
Scientific advice: Jan Willem Coebergh
Data Handling: Vera Nelen
PSA: Hugo Neels
Pathology:Ingrid Neetens
Causes of death committee:
Luc Dewilde
Herman Verhaegen,
Annemie Hermans,
Vera Nelen,
Jan Willem Coebergh

Early detection of prostate diseases Antwerp Protocol

  1. Early detection The ERSPC study wants to determine the usefullness of early detection of prostate cancer in men aged 55 to 69. In the mean time the Antwerp program wants to organise information on benign hyperplasia to be integrated in general practice.
  2. Organisation In Antwerp the study was organised by the city and the province of Antwerp, the provincial Institute for Hygiene, the Public center for social welfare and the Oncological Centre Antwerp in a cooperation with organisations of GP’s and with the financial support of the Antwerp and European community.
  3. Goals
    3.1 The European program tries to evaluate the serum analysis of Prostate Specific Antigen (PSA) as a screening tool for prostate cancer in men aged 55 to 69 years.
    3.2 Within the framework of prevention policy in Flanders we try to develop implementation of screening and decision making on treatment in primary health care.
    3.3 Sensitization of policy makers in the field of public health, medical doctors and the general public for these problems.
    3.4 Implementation of this program in total prevention policy.
  4. Method: randomised screening trial
    4.1 Men between 55 and 69 years are mailed by the city government with information about the study. In the letter is explained that participants are randomly divided into the two groups.
    4.2 The control group is referred to their own GP for routine check-up. The patient doesn’t need an extra visit for this. The check-up can happen during a regular visit of the patiënt to his GP since most people in Belgium visit their GP at least annually. This check-up can include Digital Rectal Examination (DRE). Digital rectal examination is considered basic prevention in general practice for older men in Belgium. Additional examinations are recommended with abnormal DRE or symptoms that require further investigations. In the mean time it is usefull to sensitize the patient for general prevention.
    4.3 The other half of participants is invited to come to the Oncological Centre Antwerp, Lange Gasthuisstraat 45, 2000 Antwerp, for DRE and blood sampling for PSA-analysis. The examinations are done by a GP or a nurse with several years of experience with this type of examinations. The individual results are mailed to the GP within 2 weeks. There are two categories of results:
    4.3.1. Normal If all results are normal the GP gets the test results. If screening candidates report urinary symptoms (hesitation to urinate, …) they are also referred to their GP.
    4.3.2. Suspected of prostate cancer The group of patients with elevated PSA (3 ng/ml or more) or DRE suspect of prostate cancer receive an invitation for confirmation of the diagnosis by Trans Rectal Ultrasound (TRUS) guided biopsy. The GP gets a notification of this extra examination. Trans Rectal Ultrasound (TRUS) guided biopsy. The GP gets a notification of this extra examination.
    4.4. Decision on therapy Three weeks after the examination, patients are referred to their GP for discussion on the results of biopsy. The patient, together with his GP, decides on treatment if prostate cancer was confirmed by biopsy. Treatment options are: watchfull waiting (mostly considering age, other pathology, good differentiation of tumor tissue and cells), radical surgery, radical radiotherapy or endocrine therapy.