The role of prevalence in the diagnosis of prostate cancer.
BACKGROUND
The worldwide incidence of prostate cancer has been rising rapidly, likely due to intensified effort in early detection and screening. Intense effort is also directed at novel schemas of chemoprevention and therapy. Incidence data are insufficient to identify the true magnitude of prostate cancer in a given population. The true prevalence of prostate cancer must be identified.


METHODS
We reviewed the latest worldwide epidemiologic data and clinical studies on prostate cancer studying the true prevalence of this disease.


RESULTS
The incidence of prostate cancer is increasing worldwide, with strong variation among regions. Prevalence studies based on autopsy data have confirmed a high frequency of latent prostate cancer in men of all ages. More aggressive screening measures using a lower prostate-specific antigen (PSA) threshold, together with an increasing number of biopsies, have escalated the detection of these latent cancers.


CONCLUSIONS
Recent improvements in prostate cancer detection narrow the gap between the incidence and true prevalence of prostate cancer. This, however, raises concerns about the risk of over detection of latent cancers and thus identifying a need for improvement in screening strategies to better identify clinically significant disease.
Delongchamps
Nicolas B
NB
Department of Urology, State University of New York Upstate Medical University, Syracuse, NY 13210, USA.
Singh
Amar
A
Haas
Gabriel P
GP
D014943:Global Health; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000453:epidemiology*
D017430:Prostate-Specific Antigen