Prostate cancer
Also known as: prostate cancer screening · PSA screening
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Clinically Localized Prostate Cancer: AUA/ASTRO Guideline
American Urological Association (AUA) and American Society for Radiation Oncology (ASTRO) · 2026 · 2022, amended 2026
The main US guideline for managing prostate cancer that has not spread beyond the prostate. It spans risk stratification, active surveillance, surgery, radiotherapy and follow-up, and is maintained as an amended document rather than reissued under a new title. The USPSTF separately maintains a prostate cancer screening recommendation, last issued in 2018 and listed by the Task Force as under update.
- Addresses management of clinically localized prostate cancer, including surveillance and definitive local treatment options. source
- Originally published in 2022 and carried forward through a 2026 amendment. source
- Developed by AUA and ASTRO with additional representation from ASCO and the Society of Urologic Oncology. source
EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer
European Association of Urology (EAU), with EANM, ESTRO, ESUR, ISUP and SIOG · 2026 · 2026 edition
The European reference guideline for prostate cancer, revised annually. It covers screening and early detection, diagnosis including imaging and biopsy, risk grouping, treatment of localized through metastatic disease, and follow-up. It is produced by a multidisciplinary panel drawn from urology, nuclear medicine, radiotherapy, radiology and pathology societies plus patient representatives.
- Updated on an annual cycle, with the 2026 edition current at the time of this record. source
- Developed jointly by EAU with EANM, ESTRO, ESUR, ISUP and SIOG, and includes patient representatives from Europa Uomo. source
- Recent revisions have covered EAU biochemical-recurrence risk groups, MRI in population-based screening protocols, and PSMA PET/CT staging. source
US vs EU key differences
- Scope differs: the EAU document is a single multi-society guideline spanning risk-adapted PSA screening (generally starting at age 50 and tied to individualised life expectancy), mpMRI-before-biopsy diagnosis and all disease stages, whereas the AUA/ASTRO guideline is limited to clinically localized disease and leaves early detection to a separate AUA guideline. source
- Active surveillance in favourable intermediate-risk disease is specified numerically by the EAU — ISUP grade group 2 with under 10% Gleason pattern 4 on systematic biopsies, PSA up to 20 ng/mL, cT1-2a, and no more than 50% positive systematic cores — while the AUA/ASTRO guideline frames favourable intermediate risk as a shared discussion among active surveillance, radiotherapy and radical prostatectomy without such thresholds. source
- The EAU additionally requires a confirmatory re-biopsy within 6 to 12 months for ISUP grade group 2 patients entering surveillance, to exclude sampling error. source
- Stratification frameworks differ: the EAU guideline also invokes the Cambridge Prognostic Groups alongside conventional low/intermediate/high risk categories, whereas AUA/ASTRO relies on its own risk grouping with intermediate risk split into favourable and unfavourable. source
- Update cadence differs: the EAU prostate cancer guideline is reissued annually as a full text plus pocket edition, while the AUA/ASTRO localized prostate cancer guideline is republished only when amended (2022, then replaced in 2026). source
What changed recently
- US2022 → 2022, amended 20262026-04-16
AUA amended the 2022 guideline after a literature review covering July 2021 to December 2024 (29 studies plus a set on artificial intelligence in disease management). The society describes the amendment as refining risk-based management, updating imaging and radiation therapy guidance, and strengthening the shared decision-making statements.
- EU2025 → 2026 edition2026-01-01
The EAU panel describes the 2026 text as a limited update of the 2025 publication, with revised evidence summaries and recommendations for MRI in biopsy indication and strategy, for staging, and for active surveillance strategy, plus an adapted EAU risk-group table for localised and locally advanced disease.
See the full update feed for changes across every system.