[Guidelines on the early detection of prostate cancer]

The early diagnosis of prostate cancer presents certain dilemmas, and various prostate cancer guidelines have been developed to support clinicians in decision making. However, these guidelines often give contradictory advice and should be appraised critically. We will discuss how the general practitioner (GP) should deal with the frequently used, often contradictory guidelines on this topic. A number of dilemmas concerning the early diagnosis of prostate cancer are discussed in this clinical lesson, based on a single case in the GP's practice; this concerns a 49-year-old male who approached his GP for prostate cancer screening. After the process of shared decision making, the patient was screened and diagnosed with a low-grade prostate carcinoma for which active surveillance was initiated.