Editorials

Detection of prostate cancer

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6973.140 (Published 21 January 1995) Cite this as: BMJ 1995;310:140
  1. Fritz H Schroder
  1. Chairman Department of Urology, Erasmus University, 3000 DR Rotterdam, The Netherlands

    Screening the whole population has not yet been shown to be worth while

    In August 1994 the United States Food and Drug Administration approved a blood test for use in detecting cancer of the prostate. The Hybritech Tandem assays for prostate specific antigen were recommended for use in combination with digital rectal examination. The decision was based on data from detection studies—but mainly on a recent study of 6630 men carried out in six different centres by Catalona et al.1 Clearly prostate cancer can be detected earlier and at a higher rate when this combination of tests is used. The study group concluded that “the majority of prostate cancers have spread beyond the gland when first diagnosed using the conventional detection method, digital rectal examination. With no curative therapy for advanced prostate cancer available currently or in the foreseeable future, the most promising alternative for improving the prognosis of patients is to enhance early detection.” The report went on to claim that the test improved the detection of prostate cancer confined to the gland by as much as 78% over conventional rectal examination. The proportion of cancers confined to the prostate in the 114 men who underwent surgical treatment by radical prostatectomy was 71%—an important improvement over earlier studies such as that by Van den Ouden et …

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