Can prostate cancer be NICE?

On 9 May 2019, the National Institute for Health and Care Excellence (NICE) published its updated UK guidance on prostate cancer. The publication is the culmination of a 3 year process. It is an evidence-based, carefully crafted, comprehensive "book" to compliment the pre-existing 2014 guidance. It was born from new evidence on aspects of prostate cancer treatment and, most relevant for this special edition, diagnosis. This article provides a "behind-the-scenes" on how NICE operates, using the guideline as a case study. The piece sets out to demystify this august governance body's processes: from the decision to update the existing guidance, through the scoping and discussion stages to the principles and policies that shaped the whole process. This provides the backdrop to the second half of the article wherein the 85 page guideline is condensed in to a few highly pertinent recommendations. The areas that sparked the most debate during the committee's 24-month lifespan are highlighted, finishing by asking the UK radiology community: where do we go next in this new era of multiparametric magnetic resonance imaging first?