Screening for prostate cancer remains controversial

doi:10.1136/bmj.b3601

Published 24 September 2009, doi:10.1136/bmj.b3601
Cite this as: BMJ 2009;339:b3601

Analysis

Screening for prostate cancer remains controversial

Jennifer R Stark, postdoctoral fellow of epidemiology¹^,2, Lorelei Mucci, assistant professor of epidemiology¹^,2^,5, Kenneth J Rothman, professor of epidemiology and medicine³^,4, Hans-Olov Adami, professor of epidemiology¹^,5^,6

¹ Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston MA 02115, USA, ² Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medicine School, Boston MA, ³ RTI Health Solutions, Research Triangle Institute, Research Triangle Park, NC, ⁴ Departments of Epidemiology and Medicine, Boston University Medical Center, Boston MA, ⁵ Dana Farber/Harvard Cancer Center, Boston MA, ⁶ Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm

Correspondence to: J R Stark stark@hsph.harvard.edu

Research, doi:10.1136/bmj.b3537Editorial, doi:10.1136/bmj.b3572

Two long awaited randomised trials of PSA screening have reportedthis year. However, as Jennifer Stark and colleagues explain,the results are unlikely to end the controversy over the benefitsand harms of testing

The first 150 words of the full text of this article appear below.

The introduction of prostate specific antigen (PSA) testingas a screening tool has transformed the clinical landscape ofprostate cancer. Screening allows prostate cancer to be diagnosedmany years earlier, offering hope that a newly detected canceris still localised to the prostate when treatment is curative.However, screening has also led to considerable false positiveresults and extensive overdiagnosis of disease that would nototherwise emerge clinically. We summarise current screeningguidelines and review the evidence of benefit and harm of PSAtesting.

The US Food and Drug Administration approved PSA testing tomonitor progression of cancer among men with prostate cancerin 1986 and for early detection of prostate cancer in 1994.Nevertheless, many agencies in the US and Europe do not recommendroutine prostate cancer screening (box 1). The European Associationof Urology, for instance, states that "Current published dataare insufficient to recommend the adoption of . . . [Full text of this article]

Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Del.icio.us Del.icio.us Add to Digg Digg Add to Reddit Reddit Add to StumbleUpon StumbleUpon Add to Technorati Technorati What's this?

Relevant Articles

Prostate specific antigen for early detection of prostate cancer: longitudinal study: Benny Holmström, Mattias Johansson, Anders Bergh, Ulf-Håkan Stenman, Göran Hallmans, and Pär Stattin
BMJ 2009 339: b3537. [Abstract] [Full Text] [PDF]