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Prostate cancer: screening and early detection.

M M Cookson1

  • 1Department of Urologic Surgery, Vanderbilt University School of Medicine, A1302 Medical Center North, Nashville, TN 37232-2765, USA. michael.cookson@mcmail.vanderbilt.edu

Cancer Control : Journal of the Moffitt Cancer Center
|April 28, 2001
PubMed
Summary

Prostate cancer mortality rates are declining, suggesting prostate-specific antigen (PSA) screening may be responsible for this improvement. Population-based studies indicate a benefit to PSA screening, despite ongoing controversies.

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Area of Science:

  • Urology
  • Oncology
  • Public Health

Background:

  • Prostate-specific antigen (PSA)-based screening for prostate cancer has been controversial for over a decade.
  • The impact of PSA screening on prostate cancer mortality remains a subject of debate.

Purpose of the Study:

  • To review the epidemiology, screening, early detection, and mortality related to prostate cancer.
  • To discuss PSA refinements, screening controversies, and organizational guidelines.
  • To present and discuss recent prostate cancer mortality rates in the post-PSA era.

Main Methods:

  • A comprehensive literature review was conducted.
  • Included were studies on PSA refinements, screening controversies, and guidelines.
  • Analysis of recent prostate cancer mortality rates in the post-PSA era.

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Main Results:

  • Prostate cancer mortality rates have shown a significant decline for the first time on record.
  • This decline in age-adjusted mortality rates is occurring earlier than predicted.
  • A decrease in metastatic disease, alongside mortality decline, suggests a significant contribution from PSA-based screening.

Conclusions:

  • The cost-effectiveness of prostate cancer screening is considered acceptable.
  • Ongoing randomized studies are expected to provide further insights, though results may take a decade.
  • Current evidence from population-based studies supports the benefit of prostate cancer screening.