[Screening for prostate cancer: why, how?]

Abstract

Screening for prostate cancer has been the subject of a new controversy in 2012, because of the updated and contradictory results of the two large randomized trials of prostate cancer and while the United States Preventive Services Task Force (USPSTF) recommended not use PSA in screening, because of the risk of overdiagnosis and overtreatment especially. However, this new thinking about PSA and screening may mislead the public and create a health risk. Media pressure must be an opportunity to remind the individual screening recommendations, but also to encourage innovation for better detection and better assess prostate cancer stage. New biomarkers and MRI are promising to improve screening with the PSA and DRE. The assessment of the value of PSA around 50 years is a predictor of the risk of prostate cancer and rhythm monitoring depends on the initial value and the velocity of PSA. The challenge of the coming years will be to identify patients to be treated regarding age, life expectancy and tumor aggressiveness and to identify clearly those who can benefit of active surveillance.