Impact of routine screening for adenocarcinoma of the prostate on stage distribution

The impact of routine screening with digital rectal examination for carcinoma of the prostate on stage distribution of the disease was assessed in the primary treatment population of our medical center. Two, 5-year periods were compared: 1974 to 1978--before the onset of routine screening and 1979 to 1983--during the period of routine screening of this population. The clinical stage distribution of prostatic cancer before the onset of routine screening was not significantly different from national averages. Routine screening during the latter period significantly increased the percentage of patients with clinically curable carcinoma of the prostate. Pathologically, the disease was upstaged in many patients in both series. Digital rectal examination can have a significant impact on early detection of carcinoma of the prostate within a given population but it cannot be interpreted as a panacea for this disease.