title: There are calls for a national screening programme for prostate cancer: what is the evidence to justify such a national screening programme?
abstract: BACKGROUND
  Prostate cancer is the commonest cancer in men and a major health issue worldwide. Screening for early disease has been available for many years, but there is still no national screening programme established in the United Kingdom.
  
  
  OBJECTIVE
  To assess the latest evidence regarding prostate cancer screening and whether it meets the necessary requirements to be established as a national programme for all men.
  
  
  METHODS
  Electronic databases and library catalogues were searched electronically and manual retrieval was performed. Only primary research results were used for the analysis.
  
  
  RESULTS
  In recent years, several important randomised controlled trials have produced varied outcomes. In Europe the largest study thus far concluded that screening reduced prostate cancer mortality by 20%. On the contrary, a large American trial found no reduction in mortality after 7-10 years follow-up. Most studies comment on the adverse effects of screening - principally those of overdiagnosis and subsequent overtreatment.
  
  
  CONCLUSIONS
  Further information about the natural history of prostate cancer and accuracy of screening is needed before a screening programme can be truly justified. In the interim, doctors and patients should discuss the risks, benefits and sequelae of taking part in voluntary screening for prostate cancer.
authors.affiliation: School of Medicine and Dentistry, University of Aberdeen, Foresterhill, Aberdeen, UK. a.green@abdn.ac.uk
authors.forename: A
authors.initials: A
authors.lastname: Green
authors.forename: C
authors.initials: C
authors.lastname: Tait
authors.forename: O
authors.initials: O
authors.lastname: Aboumarzouk
authors.forename: B K
authors.initials: BK
authors.lastname: Somani
authors.forename: N P
authors.initials: NP
authors.lastname: Cohen
mesh_terms: D051517:Digital Rectal Examination; D055088:Early Detection of Cancer; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D006113:United Kingdom
chemical_list: D017430:Prostate-Specific Antigen
keywords: Prostate cancer; prostate-specific antigen; screening; systematic review