Current policies on screening for prostate cancer vary worldwide. This discrepancy can be explained in part by the lack of clear evidence to support or refute such screening. Evidence is lacking for the diagnostic accuracy of current screening tests (digital rectal examination and prostate specific antigen testing) and whether screening ultimately improves survival and quality of life.1 In their study in this week's BMJ, Lane and colleagues present results from the prostate testing for cancer and treatment study, which assesses the feasibility of testing for prostate cancer in younger men (45-49 years).2

A recent systematic review1 identified two randomised controlled trials (RCTs) assessing the effectiveness of screening for prostate cancer.3 4 Both trials had several methodological weaknesses. Reanalysis of these trials using an intention to treat analysis showed no significant reduction in mortality between men randomised to screening and men in control groups (relative risk 1.01, 95% confidence interval 0.76 to 1.33). The …