Screening and early hormonal treatment of prostate cancer are accumulatingstrong evidence and support

BACKGROUND. I review the data published during the last 5 years on the effe cts of early treatment of prostate cancer on survival. METHODS. Data from prospective and randomized studies as well as from popul ation-based studies are presented. RESULTS. Two studies (European Organization for Research and Treatment of C ancer and Radiation Therapy Oncology Group) in stage T3 disease have shown that long-term (3 years or indefinite, respectively) androgen blockade prol ongs life in patients receiving androgen blockade in addition to radiothera py compared to radiotherapy alone. In the UK Medical Research Council study , androgen blockade at diagnosis of locally advanced or asymptomatic patien ts decreased cancer-specific death by 21% compared to delayed treatment. A 69% decrease in prostate cancer death was observed in the Quebec Randomized Prostate Cancer Screening Study. Population-based studies in Sweden and De nmark have shown that 62% and 63%, respectively, of patients diagnosed with localized prostate cancer will die from the disease if not treated immedia tely. Decreases in prostate cancer death rate of 6.3-23% have been found be tween 1991-1997 in the US and Canada, respectively. CONCLUSIONS. Treatment of localized disease has been shown in all the avail able randomized studies to cause a marked decrease in prostate cancer death . Simple use of the available screening procedures and treatments for local ized prostate cancer could cause a dramatic decrease in prostate cancer dea th. Prostate 43:215-222, 2000. (C) 2000 Wiley-Liss, Inc.