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Brent K. Hollenbeck, James E. Montie and John T. Wei

Defining surgical quality is an imperative and substantial undertaking before its measurement and ultimate improvement. This article defines quality of care and a rationale for its measurement. In the context of radical cystectomy for bladder cancer, we describe a conceptual model for measuring quality of care. Finally, we provide a framework for future research by presenting an overview of recent work pertaining to cystectomy and quality of care.

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Mark H. Kawachi, Robert R. Bahnson, Michael Barry, J. Erik Busby, Peter R. Carroll, H. Ballentine Carter, William J. Catalona, Michael S. Cookson, Jonathan I. Epstein, Ruth B. Etzioni, Veda N. Giri, George P. Hemstreet III, Richard J. Howe, Paul H. Lange, Hans Lilja, Kevin R. Loughlin, James Mohler, Judd Moul, Robert B. Nadler, Stephen G. Patterson, Joseph C. Presti, Antoinette M. Stroup, Robert Wake and John T. Wei

The NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer Early Detection (to view the most recent version of these guidelines, visit the NCCN Web site at www.NCCN.org) provide a set of sequential recommendations detailing a screening and subsequent workup strategy for maximizing the detection of prostate cancer in an early, organ-confined state and attempting to minimize unnecessary procedures. These guidelines were developed for men who have elected to participate in prostate cancer screening; they are not meant to address the controversy regarding population screening. Overview Prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer death in American men. More than 192,000 men will be diagnosed with prostate cancer in 2009, and an estimated 27,360 men will die of this disease.1 During the same period, nearly 20 million men in the United States will be confronted with important decisions regarding early detection for prostate cancer. Men in the United States have an approximately 1 in 6 chance of eventually being diagnosed with this malignancy and about 1 in 30 chance of eventually dying of it.2 African-American men and men with a first-degree relative with prostate cancer (especially cancer found at a younger age) have a higher risk for developing prostate cancer.2–4 In a recent study of 26,111 men, the baseline prostate-specific antigen (PSA) value was found to be a stronger predictive factor than a positive family history or being of African-American heritage.5 Men who undergo regular PSA tests have a higher chance of undergoing a...