Screening for prostate cancer

Abstract

In 2010, 217,730 men will have been diagnosed with prostate cancer (PCa) in the United States of America (USA), and around 32,730 will have died from the disease [1]. Depending on the extent of prostate-specific antigen (PSA) testing, similar ratios of incidence and mortality will be seen throughout Europe; PCa is the second commonest cause of death from cancer in men in the UK, and in the USA, it is estimated that a man aged 40 years has a 16 % chance of being diagnosed and a 3 % lifetime chance of dying from PCa [2]. Once diagnosed, the chance of a man dying from his cancer rather than other causes depends not only on the biological aggressiveness of the tumor and the age and comorbidity of the individual in question but crucially on the stage of the disease at diagnosis and, by definition, how early it has been detected. Screening for disease to allow early detection is now an integral part of modern medicine, and screening for breast, cervical, and colorectal cancer is now standard practice in some countries. Although PCa is an equally important health problem, PSA testing to screen for the disease, allowing earlier detection and thereby reducing the chance of a man dying from PCa, remains controversial with the medical community divided on whether this approach causes more harm than good.