Prostate cancer screening: the problem of overdiagnosis and lessons to be learned from breast cancer screening

Screening for prostate cancer is a relatively new procedure, still under ex perimental evaluation within prospective randomised trials. The design of p rospective studies has been mainly based on the experience of other cancer screenings, particularly breast cancer, for which data of several controlle d studies are available. Unfortunately, breast cancer is very different fro m prostate cancer, particularly for aspects such as early diagnosis and, th us the screening process, originally modelled on the basis of the lesson ta ught by breast cancer screening, needs continuous re-evaluation and adjustm ent, based on data which are now being produced from ongoing screening expe riences. In this paper, we will consider the most controversial aspects of prostate cancer screening and compare prostate screening with breast cancer screening in order to promote a better understanding of the current proble ms and lessons to be learned. (C) 2000 Elsevier Science Ltd. All rights res erved.