Prostate cancer as a public health issue in North Carolina.

Prostate cancer is a significant health problem for men in North Carolina, particularly for black men, who have one of the highest rates of prostate cancer mortality in the nation. Despite the magnitude of the problem, the value of prostate cancer screening is hotly contested among medical researchers, clinicians, and patient advocates. The Early Detection Subcommittee of the North Carolina Advisory Committee on Cancer Coordination and Control (NCACCCC) identified prostate cancer as one of four cancers for which early detection was a key issue, and set forth two goals: (1) develop a consensus regarding the public health message about prostate cancer screening, including the benefits and risks of early detection; and (2) develop research priorities for prostate cancer issues in North Carolina. Reaching these goals will require a clear understanding of the epidemiology of prostate cancer in the state, as well as the implications of screening and treatment for the disease. In this paper we do the following: (1) review prostate cancer epidemiology in North Carolina; (2) discuss the key controversial points related to screening; (3) briefly review prostate cancer research in the state; and (4) present the Advisory Committee’s current recommendations on screening for prostate cancer.