Learn More: Prostate Screening
How Prostate Cancer Screening Stands Up to the General Criteria for Screening
- Prostate Cancer certainly is a significant health problem, accounting for nearly one-third of cancers in men and nearly 40,000 deaths a year.
- Prostate Cancer can be detected before it causes problems; but prostate cancer is unique among cancers in that there is a large reservoir of latent or insignificant cancers that never cause problems. This means that many cases may be identified and treated unnecessarily.
- The treatments for early prostate cancer, namely surgery to remove the prostate or radiation to kill the cancer cells, have not been proved to reduce deaths or morbidity from prostate cancer. This does not mean that they do not; it simply means that the proper studies have not been done.
- The natural history of prostate cancer is not well understood. Doctors cannot tell which early cancers will progress to become life threatening and which will remain latent. Autopsy studies suggest that about 30 out of 100 men over the age of 50, would, if biopsied, be found to have cancerous cells in their prostates, but in about 18 of these 30, the cancers would be insignificant, meaning very small (<0.5 ml) and not likely to be life-threatening. And only 3 to 4 out of 100 men eventually die from prostate cancer.
- About 1 in 4 of those who are diagnosed with prostate cancer die from it. If you consider the prevalence of unsuspected latent prostate cancer, this proportion is much less (about 1 in 10 or less). It is not clear why only a small proportion of all cases of prostate cancer progress to death.
- Digital rectal exams and PSA tests are both safe, but there have been problems documenting their accuracy. Therefore, there is controversy as to their usefulness as tests for screening the general population.
