Screening for prostate cancer

Active screening has been advocated around the world with reference to the favorable results of breast cancer screening. The risk of overdiagnosis and subsequent overtreatment by aggressive therapies fuels the arguments against screening. The value of early detection of prostate cancer in asymptomatic stages remains to be determined. There is a lack of pretreatment prognostic factors in order to distinguish those cancers which are life threatening from those which will have a relatively benign or even asymptomatic course. The benefit of prostate cancer screening, in terms of reducing disease-specific mortality and improvement of quality of life, can probably only be proven by a randomized study. Such studies are ongoing in the USA, Canada, and Europe.