The Swedish national guidelines on prostate cancer, part 1: early detection, diagnostics, staging, patient support and primary management of non-metastatic disease

Figures & data

Figure 1. Age-standardized incidence and mortality of prostate cancer in Sweden 1960–2020. Data source: NORDCAN (https://nordcan.iarc.fr/en).

Figure 2. The Swedish national template for describing the localisation of prostate biopsies. In this example, the locations are described as C1D (Lesion A) and A4V (Lesion B).

Figure 3. The view of the patient-reported outcome measures after radical prostatectomy collected by the National Prostate Cancer Register of Sweden is available online for all operating departments for quality control and improvement.

Table

The Swedish prostate cancer risk group classification
1	Very low risk	T1c, a total of ≤ 8 mm Gleason score 6 cancer in ≤4 of 8–12 systematic biopsy cores, PSA <10 µg/l and PSA density <0.15 µg/l/cm^3
2	Other low risk	T1–T2a, Gleason score 6 and PSA <10 µg/l, but not very low risk
3	Intermediate risk	T2b–T2c and/or Gleason score 7 and/or PSA 10–19 µg/l
4	High risk	T3 on DRE or EPE/SVI 5 on MRI or Gleason score 8 or Gleason score 4 + 3 = 7 in ≥50% of systematic biopsy cores or in targeted biopsies from a PI-RADS 5 lesion or PSA 20–49 µg/l
5	Very high risk	Two or more of the high-risk criteria T3/GS 8/PSA 20–49 µg/l or T4 and/or Gleason score 9–10 and/or PSA ≥50 µg/l

Abbreviations: PSA: prostate-specific antigen, DRE: digital rectal examination, EPE: extra-prostatic extension, SVI: seminal vesicel invasion.

Table

1	Very low risk of EPE	No contact between tumour and capsule on MRI
2	Low risk of EPE	<12 mm tumour contact capsule and no signs of EPE
3	Intermediate risk of EPE	$\ge$12 mm tumour contact capsule but no signs of EPE
4	High risk of EPE	$\ge$12 mm tumour contact capsule and indirect signs of EPE
5	Very high risk of EPE	Measurable radial tumour component outside capsule

Figure 4. National register data from the National Prostate Cancer Register of Sweden for the use of different radiotherapy modalities in 2021 (npcr.se).