title: To screen or nor to screen: the prostate cancer dilemma.
abstract: The European Randomized Study of Screening for Prostate (ERSPC) has updated their previous seminal report on prostate cancer mortality comparing screened men to controls. Now with 13 years follow-up, the rate ratio of prostate cancer mortality was 0.79 favoring the screened population. The authors concluded that there was a "substantial reduction in prostate cancer mortality attributable to testing with prostate-specific antigen (PSA)" but they also stated that a "quantification of harms" needed to be addressed. The issue of harms was not addressed by the ERSPC (at least not in this report) and hence this additional statement most likely reflects the controversy currently surrounding the risks associated with over-diagnosis and treatment of indolent diseases inadvertently detected by a screening protocol. [1] In addition, the positive results from this trial conflict with those of the prostate, lung, colorectal and ovarian (PLCO) [2] study and require further elaboration.
authors.affiliation: Department of Urology and Radiation Oncology, The Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Nelson N
authors.initials: NN
authors.lastname: Stone
authors.forename: E David
authors.initials: ED
authors.lastname: Crawford
mesh_terms: D055088:Early Detection of Cancer; D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years
chemical_list: D017430:Prostate-Specific Antigen