Screening for prostate cancer

Screening for prostate cancer has shown great promise in its ability to det ect prostate cancer at a curable stage; however, significant problems exist with respect to our knowledge of its impact on prostate cancer mortality. For the properly informed patient with at least a 10-year life expectancy, it would seem that early detection efforts utilizing digital rectal examina tion (DRE) and serum prostate-specific antigen (PSA) determination are bene ficial. Considerable controversy abounds about early detection and screenin g and will continue until definitive proof of decreased prostate cancer mor tality as a result of effective early detection and treatment regimens is d emonstrated. Until then, all men with at least a 10-year life expectancy sh ould be counseled as to the potential benefits and risks. The salient liter ature is reviewed and commentary made as to the benefits of screening metho ds that can be invoked as well as their limitations and potential liabiliti es. (C) 2000 Wiley-Liss, Inc.