Prostate cancer screening in a large corporation population

The Polaroid Medical Department conducted a prostate cancer screening program of all male employees over the age of 49 years. The screening consisted of a World Health Organization (WHO) questionnaire, a digital rectal examination (DRE) by an occupational medicine doctor, and a serum prostate-specific antigen (PSA) study. There were 2241 eligible employees (males between 50 and 65 years of age). 1219 (54%) took part in the screening. Thirty-seven PSAs above the 3.9 level were found (3%) and were further evaluated with ultrasound and/or biopsy. Twelve previously unknown cancers of the prostate (1%) were discovered. The cost of the entire program to the Polaroid Medical Department, including ultrasound and biopsy studies, was $72,130 ($6,012 per cancer detected). Of the 12 cancers, two were discovered by abnormal DRE alone, eight by an elevated PSA alone, and two by both an abnormal DRE and elevated PSA. There appeared to be no correlation between the WHO symptom score and the detection of prostate cancer. Our final conclusion was that a corporate medical department screening for cancer of the prostate is both effective and cost efficient.