[Utilization of screening and treatment of prostate cancer in 2011]

Prostate cancer is the most prevalent cancer in men aged fifty or more. Resulting mortality, however, is low since most prostatic cancers are slow-growing, non-lethal tumours. The introduction of PSA screening has profoundly impacted on the epidemiology of prostate cancer. Men bearing aggressive disease are diagnosed sooner so that radical treatment can be applied more effectively. But PSA screening also unveil many indolent cancers that would have not threaten the patient if left undiscovered. Systematic treatment of indolent cancers may result into many men being exposed to unwanted side effects. For this reason, the true benefit of PSA screening is still a matter of intense debate. Nevertheless, there is room for an ethical approach of prostate cancer screening, based on information, correct identification of aggressive disease and early integration of new biomarkers.