Prostate cancer is a common and potentially serious disease

Risk factors include increasing age, family history of prostate cancer, and black race. There are few established prevention strategies

Early detection and treatment may prevent future cancer-related illness, extend life, and provide peace of mind

However, prostate cancer testing, by digital rectal examination and prostate specific antigen testing, can have false positive and false negative results and detects many cancers that would never cause symptoms.

Lower urinary symptoms such as frequency, hesitancy, night time urination, and slow stream do not increase prostate cancer risk but are associated with higher PSA values

The probability that further evaluation with a prostate biopsy will be required as a result of testing is relatively high. Biopsy can cause adverse effects including pain, bleeding, and urinary infection

Treatment options include observation, surgery, radiation, and early hormonal deprivation. Aggressive treatment is needed to realise any benefit from discovery of a tumour, but such treatment may not be necessary or effective

Treatment is associated with a small risk of death and a higher risk of side effects, particularly regarding sexual, urinary, and bowel function

Men with a life expectancy of <10-15 years (due to advanced age or a serious coexisting condition) are unlikely to benefit from routine testing