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The value of screening for prostatic carcinoma: a commentary
1Department of Urology, University of California School of Medicine, San Francisco.
Urologia Internationalis
|January 11, 1991
Summary
Routine screening for prostate cancer using digital rectal exams, ultrasound, and PSA tests does not currently reduce deaths. The costs and unproven benefits of early detection and treatment mean universal screening is not advised.
Area of Science:
- Urology
- Oncology
- Diagnostic Imaging
Background:
- Prostate cancer is a significant health concern.
- Early detection is often pursued to improve outcomes.
Purpose of the Study:
- To evaluate if routine screening methods for prostate cancer reduce mortality.
- To assess the overall benefit versus the costs and limitations of current screening techniques.
Main Methods:
- Review of evidence regarding digital rectal examinations (DRE).
- Analysis of transrectal ultrasound (TRUS) study data.
- Assessment of prostate-specific antigen (PSA) test effectiveness.
- Evaluation of treatment efficacy for detected tumors.
Main Results:
- Evidence suggests screening benefits are negated by test unreliability.
- High monetary and human costs associated with screening tests.
- Lack of proven effectiveness for treatments of detected prostate cancers.
Conclusions:
- Universal screening for prostate cancer is not currently warranted.
- Further controlled studies are needed to demonstrate the effectiveness of screening and treatment.