Prevention of Prostate Cancer Morbidity and Mortality: Primary Prevention and Early Detection

Med Clin North Am. 2017 Jul;101(4):787-806. doi: 10.1016/j.mcna.2017.03.009.

Abstract

More than any other cancer, prostate cancer screening with the prostate-specific antigen (PSA) tests increases the risk a man will have to face a diagnosis of prostate cancer. The best evidence from screening trials suggests a small but finite benefit from prostate cancer screening in terms of prostate cancer-specific mortality, about 1 fewer prostate cancer death per 1000 men screened over 10 years. The more serious harms of prostate cancer screening, such as erectile dysfunction and incontinence, result from cancer treatment with surgery or radiation, particularly for men whose PSA-detected cancers were never destined to cause morbidity or mortality.

Keywords: Prostate cancer; Prostate-specific antigen; Screening; Shared decision making.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Biomarkers, Tumor
  • Diet
  • Digital Rectal Examination
  • Early Detection of Cancer / methods*
  • Early Detection of Cancer / standards
  • Genetic Predisposition to Disease
  • Humans
  • Life Style
  • Male
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / epidemiology*
  • Prostatic Neoplasms / mortality
  • Prostatic Neoplasms / therapy
  • Racial Groups
  • Risk Factors
  • Sensitivity and Specificity
  • Time Factors
  • Watchful Waiting

Substances

  • Biomarkers, Tumor
  • Prostate-Specific Antigen