[PSA related screening of prostate cancer. Panic or improvement?]

The early detection of prostate cancer and the aggressive treatment is the only chance for a cure. The use of PSA-related screening techniques brings forward the diagnosis of the disease by 5-10 years. While such early detection regimens shift the stage at the time of detection towards locally confined disease, and while there is no doubt that early treatment is the only way of curing prostate cancer, the application of screening in practice and healthcare policy remains controversial. This is because there are uncertainties about the degree of "over-diagnosis" which most probably results from screening, and from uncertainties about the risk-benefit balance. Randomized studies will show whether early detection of prostate cancer can reduce cancer-specific mortality. Conclusive data will not be available before 2005 respectively 2008. At that time, only the validated complied information about the risks and benefits of screening and about the possible therapeutic consequences may provide a way out of this current dilemma. A synopsis of the (European Randomized Study of Screening for Prostate Cancer) was given by F. H. Schröder in the British Journal of Urology International, December 2003.