AUA and SUO Amend Advanced Prostate Cancer Guideline

The American Urological Association (AUA) and Society of Urologic Oncology (SUO) have released the 2026 amendment to the Advanced Prostate Cancer Guideline.¹

The updated document is now available online and includes 40 recommendations related to effective evidence-based care as it relates to advanced prostate cancer. The 2026 amendment includes: updated and expanded guidance regarding appropriate imaging; updated guidance on germline and somatic testing; new discussion and guidance regarding risk stratification; updated and expanded guidance regarding treatment paradigms; and updated future directions discussing ongoing developments in the field.

“This amendment reflects the significant progress made in the understanding and treatment of advanced prostate cancer,” Kristen Scarpato, MD, MPH, chair of the Guideline, said in a news release.¹ “By incorporating the latest evidence across imaging, molecular testing, risk stratification and evolving treatment paradigms, these updated recommendations are intended to support clinicians in delivering personalized, high-quality, evidence-based care for patients at every stage of advanced disease.”

Scarpato is also an associate professor, the residency program direction, and the vice chair of education in the Department of Urology, Division of Urologic Oncology, at Vanderbilt University Medical Center in Nashville, Tennessee.

What is the AUA/SUO guideline and how was it developed?

AUA/SUO’s Guideline aims to assist in clinical decision-making via evidence-based statements that were developed to provide a rational basis for treatment.² Within advanced prostate cancer, the guideline encompasses disease stages ranging from prostate-specific antigen (PSA) recurrence after exhaustion of local treatment options to widespread metastatic disease.

The guideline panel was created in 2018 by the American Urological Association Education and Research, Inc. The guideline was developed in collaboration with the American Society for Radiation Oncology and SUO, with additional representation from the American Society of Clinical Oncology.

A research librarian conducted searches in Ovid MEDLINE from 1998 to January 2019, Cochrane Central Register of Controlled Trials through December 2018, and Cochrane Database of Systematic Reviews from 2005 through February 6, 2019. An updated search was conducted prior to publication through January 20, 2020.

A methodology team developed criteria for inclusion and exclusion of studies based on the Key Questions of the guideline and the populations, interventions, comparators, outcomes, and settings of interest. Evaluation of treatment was restricted to randomized clinical trials; cohort studies were also included that evaluated therapeutic sequencing. Primary studies and systematic reviews that reported HRs or the area under the receiver operating characteristic curve were included for the evaluation of prognostic factors. Non-randomized studies of interventions and case reports, narrative reviews, case-control studies, non-English language articles, and in vitro and animal studies were excluded.

The Advanced Prostate Cancer Amendment Panel was created in 2022 by AUA to review new literature and provide updates. In 2023, the guideline was updated through AUA’s amendment process by which newly published literature was reviewed and integrated. The 2026 amendment included a PubMed literature search that spanned March 16, 2022, to August 26, 2025.

“This amendment underscores how rapidly the field of advanced prostate cancer is evolving,” Michael S. Cookson, MD, MMHC, a member of the guideline panel and former SUO president, added in the news release.¹ “From advances in imaging and molecular characterization to more refined treatment strategies, these updates reflect a more precise and increasingly personalized approach to patient care. The collaboration between AUA and SUO ensures that our patients with advanced prostate cancer benefit from the latest multidisciplinary expertise.”

References

1. American Urological Association releases advanced prostate cancer guideline amendment. News release. American Urological Association. May 12, 2026. Accessed May 12, 2026. https://www.auanet.org/about-us/media-center/press-center/american-urological-association-releases-advanced-prostate-cancer-guideline-amendment
2. Advanced Prostate Cancer: AUA/SUO Guideline (2026). American Urological Association. https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer