Screening for prostate cancer: is ultrasound the answer?

The high incidence and subsequent mortality from prostate cancer in progressively older US males is a serious health concern. Prognosis is related to extent of spread of the disease at the time of diagnosis and to pathologic grading of the tumor cells. The argument for early detection is somewhat clouded by a high incidence of latent prostate cancer related to increasing age, which may or may not progress to clinical disease. Recent applications of ultrasound technology have greatly improved our ability to image the prostate gland and raised the possibility of using ultrasound to screen for prostate cancer. The conclusions of this investigation are that ultrasound should not yet replace annual digital rectal examination as the primary screening tool, but ultrasound is a useful diagnostic adjunct. This recommendation may change with further application of the technology and as more information is gathered.