NIDDK Prostate Research Strategic Plan

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is committed to supporting and promoting research in urologic disease as part of its mission to make important medical discoveries that improve health and save lives. Central to this is the Institute's focus on disorders of the prostate and the contribution of prostate biology to overall genitourinary tract and pelvic floor physiology. The primary emphasis of the NIDDK's prostate research programs has traditionally been on benign disease. Principal among these are benign prostatic hyperplasia (BPH), along with the often associated lower urinary tract symptoms (LUTS), and prostatitis, especially chronic non-bacterial prostatitis (referred to as chronic pros-tatitis/chronic pelvic pain syndrome [CP/CPPS]). These disorders are common, chronic, and costly; they are found in all races and ethnic groups, and can affect men of all ages. In the case of BPH, symptoms increase in prevalence and severity as men age with nearly 50 percent of men experiencing LUTS by their sixth decade of life. In addition, benign prostate diseases result in significant morbidity and decreased quality of life and produce an enormous economic burden to patients and the nation from both direct health care costs and indirect costs, such as lost productivity. Despite years of research, many fundamental questions remain unanswered regarding the underlying causes of benign prostate disorders and the factors associated with disease development and progression. These long-standing, intractable questions concerning disease pathology and the need for increased progress in developing prevention and clinical care measures prompted the NIDDK to examine the state-of-the science and begin the process of developing a new vision to guide future research. To initiate this, the NIDDK convened an expert panel of clinical and basic scientists and epidemiologists in Chicago, Illinois, in the summer of 2006. This group reviewed the state of benign prostate research and the current priorities of the community and the NIDDK's prostate programs. Efforts were focused primarily on BPH/LUTS and CP/CPPS due to their relevance to the NIDDK mission. All those attending agreed that current funding and scientific trends suggested the field was in need of improved vitality and a renewed research focus. A number of the Chicago, Illinois participants became the nucleus of the NIDDK's Prostate Research Planning Committee. The present NIDDK Prostate Research Strategic Plan was developed directly through this collaborative effort and reflects the dedication and hard work of the many listed contributors. The strategic plan is organized into major sections representing four broad areas of research judged as critical for advancing the field: I. Basic Science; II. Epidemiology/Population-Based Studies; III. Translational Research; and IV. Clinical Sciences. This work serves as a guide for understanding past accomplishments and the current state of benign prostate research. More importantly, it provides research priorities and recommendations intended to focus and advance each scientific topic/area of research. In addition, each major section ends with a list of consensus high-priority recommendations. The Executive Summary serves as an overview of the plan's strategic vision and highlights key findings and recommendations. The NIDDK Prostate Research Strategic Plan is designed to be read by a broad audience of researchers, clinicians, advocacy groups, representatives from funding entities and, through our inclusion of lay/educational summaries, the patient community. The NIDDK will use recommendations and insights in this work to assist in developing future efforts addressing disease cause, prevention, and treatment. We hope it will also guide the research community and other health care professionals in addressing our common goal of improved care for patients suffering from benign disorders of the prostate.