Previous changes

March 2026 — minor update. Update to Assessment section.  

January 2026 — minor update. Added detail on the range of potential false negative testing for PSA.

August 2025 — minor update. Added prevalence data on mortality by ethnicity. Added information relating to Black men being more likely to have metastatic cancer at time of diagnosis. Revised wording on PSA testing in men over the age of 79 and added further information to the basis for information regarding the difference between advice from NICE and the AoMRC in this age group. 

June 2025 — minor update. Typographical error in PSA table corrected and a broken link replaced. 

April 2025 — minor update. Added more detailed information on PSA referral thresholds for men over the age of 79. 

March 2025 — minor update. Typographical error in PSA table corrected. 

September 2024 — minor update. Added AoMRC reference to the assessment table for PSA level. 

August 2024 — minor update. Following communication from an expert reviewer the topic has been updated to include recent research specifically on the asymptomatic nature of the presentation of prostate cancer, mortality and ethincity, prognostic models, change of terminology from Gleason score to Grade Group, additional information about PSA testing in men over the age of 79, and refinements to the outline of the active surveillance approach and applicability to different Cambridge Prognostic Groups. 

June 2024 — minor update. Meningioma added as an adverse effect of medroxyprogesterone acetate and caution is advised when prescribing medroxyprogesterone acetate to people with a history of meningioma, as per the manufacturer's updated SPC.

February 2022 — reviewed. A literature search was conducted in January 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. The main changes to the topic are as follows:

• Recommendations on risk stratification for people with newly diagnosed prostate cancer has been updated in line with the updated National Institute for Health and Care Excellence (NICE) guideline Prostate cancer: diagnosis and management [NICE, 2021]. 
  • The 2019 NICE guideline used a 3-tier model for risk stratification. The NICE guideline development committee agreed that newer evidence shows 5-tier risk stratification models are better at predicting prostate cancer-specific mortality than 3-tier models. More accurate prognosis will mean that more people are given the most effective treatment. The committee recommended the 5-tier Cambridge Prognostic Group (CPG) model over other 5-tier models because it has been tested in UK populations.
• The information on age-specific prostate-specific antigen (PSA) thresholds for people with possible symptoms of prostate cancer and recommendations on referral for suspected prostate cancer have been updated in line with the updated NICE guideline Suspected cancer: recognition and referral [NICE, 2021].
  • For a short explanation of why the NICE guideline committee made the 2021 recommendation and how it might affect practice, see the rationale and impact section on PSA testing for prostate cancer.
  • Full details of the evidence and the NICE committee's discussion are in evidence review A: PSA testing for prostate cancer.
• The topic structure has been changed.

June 2021 — minor update. Links to Prostate Cancer UK patient resources updated.

February 2021 — minor update. Clarification of wording in prostate-specific antigen (PSA) referral for men aged 50–69 years 

October 2017 — minor update. Changes made to age ranges in the section on interpreting PSA results to reflect Public Health England (PHE) and UK National Screening Committee (UK NSC) guidance. 

July to August 2017 — reviewed. A literature search was conducted in August 2017 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. Structural changes have been made to this topic, and recommendations on PSA testing and treatments for prostate cancer have been updated in line with the latest National Institute for Health and Care Excellence (NICE) guidance.

November 2016 — minor update. The NICE quality standards for suspected cancer have been added to this topic.

May 2014 — minor update. The word prescriptions has been removed from the section on suspected spinal cord compression.

December 2013 — minor update. Broken link to Prosdex option grid fixed.

May 2013 — minor update. References to the Prostate Cancer Charity and all relevant links have been updated to Prostate Cancer UK. Duplicate links have also been removed.

March 2013 — minor update. The telephone number for NHS Direct has been updated.

January 2011 — minor correction of information about degarelix.

October 2010 to January 2011 — this is a new CKS topic. The evidence base has been reviewed in detail, and recommendations are clearly justified and transparently linked to the supporting evidence.

New evidence

Evidence-based guidelines

• European Association of Urology (2024) Prostate cancer [Free full-text]

HTAs (Health Technology Assessments)

No new HTAs since 1 February 2022.

Economic appraisals

No new economic appraisals relevant to England since 1 February 2022.

Systematic reviews and meta-analyses

• European Journal of Oncology (2024) Comparing the Performance of Digital Rectal Examination and Prostate-specific Antigen as a Screening Test for Prostate Cancer [Free-full text] 

Primary evidence

• BMC Medicine (2018) Gnanapragasam V et al The Cambridge Prognostic Groups for improved prediction of disease mortality at diagnosis in primary non-metastatic prostate cancer [Free full-text]
• Harding, T. A., Martin, R. M., Merriel, S. W., et al. (2024). Optimising the use of the prostate-specific antigen blood test in asymptomatic men for early prostate cancer detection in primary care: report from a UK clinical consensus. British Journal of General Practice, 74(745), e534-e543. [Abstract]
• Manfredi, C., Franco, A., Ditonno, F., et al. (2024). Prevalence and Factors Associated With Prostate Cancer Among Transgender Women. JAMA oncology. [Abstract]

New policies

No new national policies or guidelines since 1 February 2022.

New safety alerts

No new safety alerts since 1 February 2022.

Changes in product availability

No changes in product availability since 1 February 2022.

What is the staging for prostate cancer?

Table 2. Tumour Node Metastasis (TNM) classification of prostate cancer.

What is the Grade Group?

• The Grade Group scoring system is an internationally recognized grading system, based on examination of prostate tissue. It estimates the grade of prostate cancer according to its architectural differentiation. This was previously known as the Gleason score. 
  • When the prostate is biopsied, 10–12 cores are taken from different parts of the gland (5 or 6 per side). The two most common tumour patterns are analyzed and graded from 1–5:
    • Grade 1: small, uniform glands with minimal nuclear changes.
    • Grade 2: medium-sized acinii, separated by stromal tissue but more closely arranged.
    • Grade 3: marked variation in glandular size and organization and infiltration of stromal and neighbouring tissues.
    • Grade 4: marked atypical cytology with extensive infiltration.
    • Grade 5: sheets of undifferentiated cells.

[National Collaborating Centre for Cancer, 2019]  [EUA, 2024]

Prognostic stratification for localized or locally advanced prostate cancer

Table 3. Risk stratification for men with localized prostate cancer according to prostate-specific antigen (PSA) level, Grade Group, and Tumour Node Metastasis (TNM) clinical stage.

Prostate-specific antigen (PSA) testing

• Prostate-specific antigen (PSA) is a protein produced by the prostate gland. It is secreted by prostate epithelial cells into prostatic fluid, where its function is to liquefy semen and thus allow spermatozoa to move more freely. Although PSA is secreted into prostatic fluid and semen, small amounts are present in blood. 
  • Men with prostate cancer tend to have higher levels of PSA in their blood — as a result of altered prostate architecture in prostate cancer, more PSA leaks out increasing the levels in the blood. 
  • However, blood PSA is an inaccurate marker for prostate cancer because cancer can be present without increased PSA levels, and PSA levels may be increased by conditions other than cancer (such as benign prostatic enlargement, prostatitis, and urinary tract infection). Also, PSA levels tend to increase naturally with age.
• The aim of PSA testing is to detect early prostate cancer when treatment can be offered that may cure cancer or extend life. PSA levels increase normally. See the age-specific PSA threshold table to guide referral decisions. 
  • Most men will have a PSA level less than 3 nanograms/mL. About 3 in 4 men with a raised PSA level (3 nanograms/mL or higher) will not have cancer. Around 15% of men with a normal PSA do have cancer.
  • A PSA test will not distinguish between aggressive tumours (which are at an early stage but will develop quickly) and those which are not. Further tests may provide valuable information.
• PSA testing should be:
  • Considered in men with suspected prostate cancer.
  • Offered to men who have a BRCA 2 gene variant - as part of the proposed screening programme.
• Before a PSA test, people should not have:
  • An active urinary infection or within previous 6 weeks.
  • Ejaculated in previous 48 hours.
  • Exercised vigorously, for example cycling, in the previous 48 hours.
  • Had a urological intervention such as prostate biopsy in previous 6 weeks.

Information and advice on prostate-specific antigen (PSA) testing

Before offering prostate-specific antigen (PSA) testing, appropriate information should be provided to enable the person to make an informed choice about testing. 

•  Benefits of PSA testing include:
  
  • Early detection — PSA testing may lead to prostate cancer being detected before symptoms develop.
  • Early treatment or entry into an active surveillance programme — detecting prostate cancer early before it progresses to cause morbidity or limit life expectancy. 
• Limitations and risks of PSA testing include:
  
  • False-negative PSA tests — some authors quote a rate of up to 15% of those with a normal PSA level (less than 3 nanograms/mL) who may then subsequently develop prostate cancer. 
  • False-positive PSA tests — about 75% of people with a raised PSA level (3 nanograms/mL or higher) have a negative prostate biopsy.
  • Unnecessary investigation — a false positive PSA test may lead to invasive investigations, such as prostate biopsy, and there may be adverse effects (for example bleeding or infection).
  • Unnecessary treatment — slow-growing tumours are common and may not cause any symptoms or shorten life. Some tested men may therefore face unnecessary diagnosis (overdiagnosis) of prostate cancer, as well as associated anxiety, medical tests, and treatments with adverse effects. 
  • There is a particular risk of over-diagnosing and overtreating prostate cancer in men over the age of 79 where the prevalence is highest but the proportion of cancers which are clinically significant is lowest. For many patients in this group although they may have prostate cancer it will not cause symptoms or impact their life expectancy. Tests and treatment may cause additional risks and anxiety. 
• See the NHS information page regarding PSA testing.
• Sources of additional information on PSA testing include:
  • Cancer Research UK (www.cancerresearchuk.org). 
  • Prostate Cancer UK (www.prostatecanceruk.org). 
  • Macmillan Cancer Support (www.macmillan.org.uk).
  • Healthtalk.org (www.healthtalk.org).
  • East of England NHS Cancer Alliance 'Know your options' (Prostate cancer: knowing your options :: East of England Cancer Alliance). 

Basis for recommendation

These recommendations are based largely on the National Institute for Health and Care Excellence (NICE) guidelines Prostate cancer: diagnosis and management [NICE, 2021b] and Suspected cancer: recognition and referral [NICE, 2021c], and the Public Health England (PHE) guidelines Prostate cancer risk management programme: overview [PHE, 2016] and Advising well men about the PSA test for prostate cancer: information for GPs [OHID, 2024]. The note regarding the lack of sensitivity for DRE in detecting prostate cancer in the absence of a raised PSA is based on a meta-analysis [Matsukawa, 2024] and a retrospective study [Sajjad, 2022]. The range of PSA false-negatives is taken from a review article Prostate cancer screening with prostate-specific antigen (PSA) test: a clinical practice guideline [Tikkinen, 2018] and a retrospective analysis What is an acceptable false negative rate in the detection of prostate cancer? [What is an acceptable false negative rate in the detection of prostate cancer?]. 

When to refer

• The information on age-specific prostate-specific antigen (PSA) thresholds for people with possible symptoms of prostate cancer and recommendations on referral for suspected prostate cancer are based on the NICE guideline Suspected cancer: recognition and referral [NICE, 2021c]. In this document NICE advise that PSA testing levels and referral to specialists should be based on clinical judgement. Whereas the Academy of Medical Royal Colleges PSA Testing for men aged 80 and above [AoMRC, 2024] and the NHS England GIRFT guidance Towards Better Diagnosis & Management of Suspected Prostate Cancer [NHS England, 2024] advise that in men over the age of 79 who have a level of more than 20 or more than 7.5 and there are symptoms suggestive of metastatic disease (bone pain and/or fatigue and/or significant unintended weight loss) should be referred. 
  • For a short explanation of why the NICE guideline committee made the 2021 recommendation and how it might affect practice, see the rationale and impact section on PSA testing for prostate cancer. The guideline development group advised that 'No evidence was available specifically for people under 40 or over 79, and so the committee recommended that clinical judgement is used when deciding whether to refer people in these groups to secondary care'. 

     

  • Full details of the evidence and the NICE committee's discussion are in evidence review A: PSA testing for prostate cancer.

Basis for recommendation

This information is largely based on the recommendation issued by the UK National Screening Committee (UK NSC) [UKNSC, 2026].

Harms associated with prostate screening

There are several harms associated with screening. They are a consequence of the additional tests that men have to get a prostate cancer diagnosis (including a biopsy of the prostate) and the treatment they may then receive. Harms can arise as early as 2 weeks after beginning treatment, and can persist for a very long time (6 years or more, or possibly a lifetime).

For example, after 6 months for men undergoing prostate surgery [NICE, 2021b]:

• 71% will find it difficult to control their bladder.
• 19% will be unable to control their bladder (moderate to severe urinary incontinence).
• 3% will have moderate to severe impacts on their bowel habits.
• 66% will experience moderate or severe erectile dysfunction.

For men undergoing radiotherapy [NICE, 2021b]:

• 38% of men will find it difficult to control their bladder.
• 6% will have moderate to severe urinary incontinence.
• 5% will have moderate to severe impacts on their bowel habits.
• 48% will have moderate or severe erectile dysfunction.

Around 80% of men whose prostate cancers are identified through screening have cancers that would not be life-threatening and could be left alone without getting worse or affecting their lives [UKNSC, 2026]. These men will therefore receive treatment they do not need and the harms of screening will quickly outweigh any benefit.

The UK Cluster Randomised Trial of PSA Testing for Prostate Cancer (CAP Trial) reported that a one-off PSA test to men regardless of their risk was associated with a small reduction in mortality after 10 years: out of every 1,000 men invited for a PSA test, one less man died from prostate cancer than would have without a screening programme [Martin, 2018]. But, even with only a one-off screen, men were still at a very high risk of being overdiagnosed and overtreated for prostate cancer.

A second analysis of the CAP data was published in 2024 and this study reported that the risk of death 15 years after the PSA test was reduced by only 0.09% compared to men who were not invited to have a PSA test [Martin, 2024]. This UK study highlighted that a one-off PSA test to screen for prostate cancer had a small effect on mortality from prostate cancer and no effect on overall survival. Yet, the harms from treatments (see above) were apparent in men at the 15-year follow-up.

Further research

The Transform trial, researching the best ways to detect prostate cancer earlier, will be expanded so that all eligible Black men – aged 45 to 74, who have not had a PSA test or prostate MRI scan in the last five years – will be invited to take part in stage 2 of the trial [UKNSC, 2026].

How is prostate cancer managed?

• Management of prostate cancer will be initiated and managed in secondary care.
  • Follow up and monitoring, as well as early recognition and initial management of complications of the condition and adverse effects of its treatment can be carried out in primary care under shared care arrangements. 
• Management options in secondary care depend on the man's prognostic risk.
  • This is determined by taking into account: 
    • The clinical staging of the disease.
    • Results of the prostate-specific antigen (PSA) test.
    • The Grade Group.
    • The person's age, comorbidities, and preference. 
  • Treatments options include: 
    • Watchful waiting.
    • Active surveillance.
    • Radical treatments, such as radical prostatectomy, external beam radiotherapy, and brachytherapy. 
    • Adjunctive and palliative treatments, such as hormone therapy, chemotherapy, or bisphosphonates. 
  • For detailed information on treatment options for localized and locally advanced prostate cancer, see the National Institute for Health and Care Excellence (NICE) guideline Prostate cancer: diagnosis and management.
    • The Predict Prostate patient decision aid is endorsed by NICE and supports the NICE guideline on prostate cancer. Produced by the University of Cambridge Academic Urology Group, it compares the potential outcomes of different treatment options for people with non-metastatic prostate cancer.
• Offer men with prostate cancer advice on how to access information and support from websites, local and national cancer information services, and from cancer support groups, including: 
  • Cancer Research UK (www.cancerresearchuk.org).
  • Prostate Cancer UK (www.prostatecanceruk.org).  
  • Macmillan Cancer Support (www.macmillan.org.uk).
  • Movember UK (www.movember.com).
  • Orchid - Fighting Male Cancer (www.orchid-cancer.org.uk).
  • Tackle Prostate Cancer (www.tackleprostate.org).
  • The NHS website (www.nhs.uk).
  • Healthtalk.org (www.healthtalk.org).
  • East of England NHS Cancer Alliance 'Know your options' (https://www.canceralliance.co.uk/prostate). 

How should I follow up and monitor a person with prostate cancer?

People with prostate cancer should be followed up in primary care in line with locally agreed protocols.

• For people who are being managed with watchful waiting:
  • Measure prostate-specific antigen (PSA) levels at least once a year.
  • Digital rectal examination (DRE) is not recommended on a routine basis while the PSA level remains at baseline values.
  • People with localized prostate cancer who have chosen watchful waiting and who have evidence of significant disease progression (that is, rapidly rising PSA level or bone pain) should have their situation reviewed by a urological cancer specialist.
  • Follow up people with prostate cancer who have chosen a watchful waiting regimen with no curative intent in primary care only if protocols for this have been agreed between the local urological cancer multidisciplinary team (MDT) and the relevant primary care organization(s).
• For people who are being managed with active surveillance:
  • In year 1 of active surveillance:
    • Every 3–4 months: measure prostate-specific antigen.
    • Throughout active surveillance: monitor PSA kinetics (could include PSA density and velocity).
    • At 12 months: perform a DRE.
    • At 12–18 months: multiparametric MRI.
  • In year 2 and every year thereafter until active surveillance ends:
    • Every 6 months: measure PSA.
    • Throughout active surveillance: monitor PSA kinetics (could include PSA density and velocity).
    • Every 12 months: perform a DRE.
  • If there is concern about clinical or PSA changes at any time during active surveillance, the person should be reassessed with multiparametric MRI and/or re-biopsy.  
• For people who are being managed with radical treatment:
  • PSA levels should be measured no earlier than 6 weeks after treatment, then at least every 6 months for 2 years, and once a year thereafter.
  • After at least 6 months' initial follow up, consider a remote follow-up strategy for people with a stable PSA who have had no significant treatment complications, unless they are taking part in a clinical trial that needs formal clinic-based follow up.
  • Do not routinely offer DRE to people with localized prostate cancer who are not on active surveillance while their PSA remains at baseline levels.
• For all people with prostate cancer:
  • Review and manage:
    • Complications of the disease, including pain, lower urinary tract symptoms, and symptoms of spinal cord compression.
    • Adverse effects from treatment, including sexual dysfunction and urinary incontinence. Adverse effects of androgen withdrawal include change in body shape and weight gain, tiredness, hot flushes, loss of libido, erectile dysfunction, gynaecomastia, and loss of bone density.
    • Impact on quality of life.
  • If biochemical relapse (rising PSA level) occurs, calculate an estimate of PSA doubling time based on a minimum of three measurements over at least 6 months.
  • Refer men with evidence of significant disease progression (rapidly rising PSA level or bone pain) to a urological cancer specialist.

How should I manage complications and adverse effects of treatment for prostate cancer?

Contraindications and cautions

• Do not prescribe medroxyprogesterone acetate to people with:
  • Acute liver disease, or a history of liver disease as long as liver function tests have failed to return to normal.
  • Previous idiopathic or current venous thromboembolism.
  • Active or recent arterial thromboembolic disease (for example, angina, myocardial infarction).
  • Porphyria.
  • Known, past, or suspected breast cancer.
• Prescribe medroxyprogesterone acetate with caution to people with:
  • Asthma.
  • A history of meningioma.
  • Cardiac dysfunction.
  • Cholelithiasis.
  • Conditions that may worsen with fluid retention.
  • Diabetes (progestogens can decrease glucose tolerance — monitor person closely).
  • Epilepsy.
  • History of depression. 
  • History of, or risk factors for, thromboembolic disorders.
  • Hypertension.
  • Liver disorders (for example, liver adenoma — seek specialist advice before use).
  • Migraine.
  • Otosclerosis.
  • Positive antiphospholipid antibodies.
  • Systemic lupus erythematosus.
  • Rheumatoid arthritis.

[Joint Formulary Committee, 2021; EMC, 2024]

Adverse effects

• Possible adverse effects include:
  • Common or very common
    • Alopecia, constipation, depression, dizziness, fatigue, fluid retention, headache, hyperhidrosis, hypersensitivity, insomnia, increased appetite, nausea, nervousness, oedema, sexual dysfunction, skin reactions, tremor, weight changes, vomiting.
    • Congestive heart failure, corticoid-like effects, diabetes exacerbation, diarrhoea, drowsiness, dry mouth, embolism and thrombosis, euphoric mood, fever, galactorrhoea, hirsutism, hypercalcaemia, muscle spasms, tachycardia.
  • Rare or very rare
    • Cerebral infarction, jaundice; malaise, myocardial infarction.
  • Frequency not known
    • Adrenergic-like effects, cataract diabetic, concentration impaired, confusion, glycosuria, palpitations, visual impairment (discontinue if papilloedema or retinal vascular lesions).
    • Meningioma — discontinue treatment with medroxyprogesterone acetate if meningioma is diagnosed. 

[Joint Formulary Committee, 2021]

Drug interactions

• The metabolism of progestogens may be increased by concurrent use of drugs known to induce drug-metabolizing enzymes (specifically cytochrome P450 enzymes), such as: 
  • Antibiotics — rifampicin and rifabutin are very potent liver enzyme inducers.
  • Antiepileptics — carbamazepine, oxcarbazepine, phenytoin, barbiturates, primidone, and topiramate.
  • Antiretrovirals — ritonavir, ritonavir-boosted protease inhibitors, efavirenz, and nevirapine.
  • St John's wort.

[ABPI, 2020a]

Contraindications and cautions

• Do not prescribe cyproterone acetate to people with:
  • Liver diseases (including Dubin–Johnson syndrome or Rotor syndrome).
  • Meningioma or a history of meningioma.
  • Previous or existing liver tumours (only if these are not due to metastases from carcinoma of the prostate).
  • Wasting diseases (with the exception of inoperable carcinoma of the prostate).
  • Existing thrombosis or embolism.
  • Malignant diseases (except for prostate cancer).
  • Rotor syndrome.
• Prescribe cyproterone acetate with caution to people with: 
  • Diabetes mellitus.  
  • Sickle cell anaemia. 
  • A history of arterial or venous thrombotic or thromboembolic events (for example deep vein thrombosis, pulmonary embolism, myocardial infarction).
  • A history of cerebrovascular disease.
  • Advanced cancer.
  • Severe depression.
• Because of the risk of hepatic toxicity, liver function tests should be performed before treatment, regularly during treatment, and whenever any symptoms or signs suggestive of hepatotoxicity occur are present. Stop treatment if hepatotoxicity occurs unless the hepatotoxicity is due to other causes (for example, metastatic disease). 

[ABPI, 2020b; Joint Formulary Committee, 2021]

Adverse effects

Possible adverse effects of cyproterone acetate include:

• Common or very common
  • Depressed mood, dyspnoea, fatigue, gynaecomastia, hepatic disorders, hot flush, hyperhidrosis, nipple pain, restlessness, weight change.
• Uncommon
  • Skin reactions.
• Rare or very rare
  • Galactorrhoea; meningioma (increased risk with increasing cumulative dose); neoplasms.
• Frequency not known
  • Adrenocortical suppression, anaemia, azoospermia, hair changes, hypotrichosis, osteoporosis, sebaceous gland underactivity (may clear acne), thromboembolism.
• In addition, direct hepatic toxicity, including jaundice, hepatitis, and hepatic failure, has been reported (fatalities reported, usually after several months, at dosages of 100 mg and above).
  • If hepatotoxicity is confirmed, cyproterone should normally be withdrawn unless the hepatotoxicity can be explained by another cause, such as metastatic disease (in which case it should be continued only if the perceived benefit exceeds the risk).

[Joint Formulary Committee, 2021]

Drug interactions

• Possible drug interactions may occur with:
  • Thiazolidinediones (pioglitazone and rosiglitazone) — cyproterone acetate may inhibit the liver enzyme CYP2C8, and thiazolidinediones are substrates of CYP2C8. Increased blood levels of these antidiabetics may require dose adjustment.
  • Statins (for example, simvastatin and atorvastatin) — the risk of statin-associated myopathy or rhabdomyolysis may be increased when co-administered with cyproterone acetate, as both statins and cyproterone acetate are metabolized by the CYP3A4 enzyme. 
  • Other inhibitors of the CYP3A4 enzyme — clinical interaction studies have not been performed, but it is expected that strong inhibitors of CYP3A4, such as ketoconazole, itraconazole, clotrimazole, and ritonavir, will inhibit the metabolism of cyproterone acetate and increase the plasma levels.
  • Inducers of the CYP3A4 enzyme — inducers of CYP3A4, such as rifampicin, phenytoin, and St John's Wort, may reduce the levels of cyproterone acetate.

[ABPI, 2020b]

Prescribing information on tamoxifen

• For prescribing information on tamoxifen, see the CKS topic on Tamoxifen - managing adverse effects.