[Increased incidence of prostatic cancer. The significance of prostate-specific antigen]

Patients with newly diagnosed prostate cancer who were registered in one hospital during two recent one-year periods were studied with regard to causes and consequences of the diagnosis. 65 new cases were registered in 1991 and 102 in 1994. These constitute about 90% of all new cases in the area served by the hospital, and are representative of the population to this extent. In only one of the 16 patients treated with curative intent was the diagnosis made as a consequence of routine determination of prostate specific antigen (PSA) when he was asymptomatic. On the other hand, PSA-assay in asymptomatic men led to an increasing number of patients being made aware of a disease for which no treatment was recommended. This was partly because most of the patients diagnosed in this manner were elderly (mean age 72). A plea is made to restrict this practice to younger men.