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Related Experiment Video

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A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance

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Published on: November 7, 2025

Screening for prostate cancer: early detection or overdetection?

Andrew J Vickers¹, Monique J Roobol, Hans Lilja

¹Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA. vickersa@mskcc.org

Annual Review of Medicine

|November 8, 2011

Summary

Prostate cancer screening with PSA reduces deaths but leads to overtreatment. Optimizing screening programs by risk stratification and appropriate treatment selection can improve outcomes and reduce costs.

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Area of Science:

Urology
Oncology
Public Health

Background:

Prostate-specific antigen (PSA) screening for prostate cancer can decrease cancer mortality.
However, current screening practices lead to significant overtreatment and associated costs.

Purpose of the Study:

To evaluate the benefits and costs of prostate cancer screening.
To identify strategies for optimizing prostate cancer screening programs to maximize benefits and minimize harms.

Main Methods:

Review of randomized trial evidence on prostate cancer screening.
Analysis of current U.S. clinical practices in prostate cancer screening and treatment.

Main Results:

PSA screening reduces prostate cancer mortality but requires extensive screening, biopsy, and treatment to prevent one death.
Current practices often involve screening men unlikely to benefit and overtreating low-risk cancers.
Treatment is frequently administered at low-volume centers, potentially reducing efficacy.

Conclusions:

Risk-stratified screening and biopsy can improve the benefit-to-cost ratio of prostate cancer screening.
Increased use of active surveillance for low-risk cancers and centralization of radical prostatectomy to high-volume surgeons are recommended.
Optimizing radiotherapy dosage is also crucial for improving outcomes and reducing overtreatment in prostate cancer care.