To screen or not to screen? 1992

L J Denis
Department of Urology, A.Z. Middelheim, Antwerp, Belgium.

This paper aims to present a case for screening for prostate cancer, though medical committees from many countries have recently decided against it. It is clear that prostate cancer fails many of the criteria for an effective screening program. There is certainly no single test that can be used reliably to detect prostate cancer. All the available tests have advantages and disadvantages. The sensitivities of the three widely used screening tests--digital rectal examination (DRE), prostate specific antigen (PSA), and transrectal ultrasound (TRUS)--vary from 50% to 85% in a number of studies, but the positive predictive value fluctuates around 30%. The use of all three tests must improve the detection rate. The European Cancer Programme is funding a pilot study in Antwerp and Rotterdam on screening for prostatic diseases. In Rotterdam, a pre-screen PSA is performed and then patients are randomized to no screening or DRE with TRUS. The Antwerp section of the study includes screening for benign prostatic hyperplasia and employs a questionnaire on urinary symptoms as a pre-screen test. Patients are then randomized to controls or DRE with TRUS and, if results are suspicious, PSA measurement. It will be about 8 years before it becomes clear whether there is a resulting drop in mortality from prostate cancer.

UI MeSH Term Description Entries
D008297 Male Males
D008403 Mass Screening Organized periodic procedures performed on large groups of people for the purpose of detecting disease. Screening,Mass Screenings,Screening, Mass,Screenings,Screenings, Mass
D011471 Prostatic Neoplasms Tumors or cancer of the PROSTATE. Cancer of Prostate,Prostate Cancer,Cancer of the Prostate,Neoplasms, Prostate,Neoplasms, Prostatic,Prostate Neoplasms,Prostatic Cancer,Cancer, Prostate,Cancer, Prostatic,Cancers, Prostate,Cancers, Prostatic,Neoplasm, Prostate,Neoplasm, Prostatic,Prostate Cancers,Prostate Neoplasm,Prostatic Cancers,Prostatic Neoplasm
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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